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OSTEOPATHIC 
GYNECOLOGY 

The Diseases of Women 



OBSTETRICS 



The Great and Growing Danger of Newly 

Wedded Women. The Great Danger 

of Women at the Climacteric 



HOW TO MAKE MEN RESPECT 
MARRIAGE VOWS 



By 

Chas. H. Murray, A. B., B,. D D. O. 

li Author of 

Practice of Osteopathy, with 108 Halftone 

Engravings, The Osteopathic Truth, 

Genuine Osteopathy, Etc., Etc. 



ELGIN, ILLINOIS 
1912 



1^ 



<?'! 



Copyright, 1912 
By Chas. H. Murray 



€CU305916 



PREFACE 



Since giving to the public my work on the Practice 
of Osteopathy in relation to the general diseases I 
have concluded that there was needed a simple yet 
very thorough work on the diseases of women. It is 
in this realm that Osteopathy does its best work, and 
here the reputation of the science was largely won. 
No class of patients respond better to the treatment 
and none are more grateful than those relieved from 
the torture of pelvic diseases and the ills that are com- 
mon to many women. 

With some practitioners of the science, the treat- 
ment of these troubles constitutes a very large portion 
of their practice, and it is the hope of the author that 
he has greatly simplified the technique of the treat- 
ment and in many cases added to its effectiveness. He 
has great confidence in the treatment, as he has been 
uniformly successful in applying it for a number of 
years to a large clientele, and believes he has devel- 
oped it to some extent. The annoyance in giving local 
treatment has been largely overcome, and the author 
has learned to accomplish the desired end with very 
little such work, and believes that the patients improve 
much faster. It is his hope that this book will be as 
well received as his Practice of Osteopathy and will 
prove as effective in its helpfulness. 

Chas. H. Murray. 

465 Douglas Ave. 
Elgin, Illinois. 



ILLUSTRATIONS 

PART I 

Pag-e 
Fig. No. A. Knee Chesit Position, 49 

" " B. Elevated Pelvic Position, 50 

" '' C. Depressed Pelvic Position, 51 

" " D. Trendelenburg Position, . 52 

L-C. " 1. Laxus-Cycle, 134 

L-C, '' 2. For Gentle Treatment, 135 

L-C, " 3. Taking a Gentle Treatment, 136 

L-C, '' 4. A Harder Treatment, 137 

L-C, '' 5. Part for Severe Treatment, 138 

L-Ci '* 6. Taking a Severe Treatment, 139 

L-C, " 7. Detached Part Laxus-Cycle, 140 

L-C, '' 8. Treating the Spine, 141 

L-C, " 9. Treating the Abdomen, 142 

L-C, " 10. Treating the Leg, 143 



8 , Illustrations 

PART II 

Pig. No. Page 

1. Treating the Neck, 10 

2. Dressed for a Treatment, 11 

3. Severe Treatment for the Neck, 14 

4. Treatment of Contracted Scaleni Muscles, 15 

5. Relaxing Neck Muscles, 18 

6. Work Over the Hyoid Bone, 19 

7. The Pneumogastric Nerve, 22 

8. Great Occipital Nerves, 23 

9. Ireating Great Auricular and Other Nerves, ..... 26 
9A. Superior Cervical Ganglion, 27 

10. Headaches, 30 

11. Springing Lower Jaw, 31 

12. Relaxing Neck Muscles, 34 

13. Ligamentous Lesions, 35 

14. Relaxing Posterior Neck Muscles, 38 

15. Another Method for Posterior Neck Tissues, .... 39 

16. Spiral Treatment of Neck Muscles, 40 

17. Reducing Atlas Lesions, 41 

18. Stretching Neck Tissues, 42 

19. Relaxing Anterior Neck Tissues, 43 

20. Treating the Fifth Nerve, 44 

21. Relieving Pressure in Veins of Head, 45 

22. Treating the Skull, 48 

23. Freeing Structures of Nose, 49 

24. Opening the Tear Duct, 52 

25. An Eye Treatment, 53 

26. Fifth Nerve Treatment Below Malar Bones, 54 

27. Treating Cataract, 55 

28. A Normal Spine, 56 

29. A Normal Spine, 57 

30. Examining Spinal Processes, 60 

31. Treating Spinal Muscles, 61 

32. Springing the Spine, 62 

33. Examining Various Vertebrae, , 63 

34. Beginning the Treatment, 64 



Illustrations 9 

Fig. No. ^ Page 

35. Replacing Vertebrae, 65 

36. Treating the Spine, 68 

Z7, The Head and Neck as Levers, 69 

2>^. A Most Efficient Treatment, 70 

39. An Effective Dorsal Treatment, 71 

40. Raising Ribs, 72 

41. Raising Ribs, ? 73 

42. Use of Knee in Treating the Spine, 74 

43. Relaxing Lumbar and Sacro-iliac Regions, 75 

44. Correcting Spinal Vertebrae, 78 

45. Stretching Spine, 79 

46. Spinal Curvature, 80 

47. Stretching Side of Back in Spinal Curvature, .... 81 

48. Relaxing Tissues of Back, 82 

49. Torsion Spinal Treatment, 83 

50. Stimulating Spinal Nerves, 84 

51. Correcting Posterior Vertebrae, 85 

52. A Severe Spinal Treatment, 88 

53. Replacing Posterior Vertebrae, a Severe Treatment, 89 

54. Manipulating the Shoulder, 90 

55. Treating the Scapulae, 91 

56. Loosing the Tissues Under the Scapulae, 92 

57. Rotating the Shoulder, • 93 

58. Correcting Upper Dorsal Vertebrae, 94 

59. Manipulating Spinal Tissues, 95 

60. Torsion of Side, 98 

61. Torsion of Side, Opposite Movement, 99 

62. Springing Scapulae, 100 

63. A Variation of the Above, 101 

64. Treating a Child, 102 

65. Relaxing Lumbar Ligaments, 103 

66. Inhibition, 104 

67. Sacrum Lesions Reduced, 105 

68. Treating Spinal Vertebrae, 110 

69. Discovering Tender Spots in Spine b}^ Pressure 

on Head, Ill 

70. Treating Clavicle, 112 



10 Illustrations 

Fig. No. Page 

71. Raising Clavicle, 113 

12, Treatment of First Rib, 114 

IZ. Elevating First and Second Ribs^ 115 

74. First Rib Lesions, 116 

75. Lower Rib Lesions, 117 

Td. Another Rib Treatment, 120 

n. Raising Ribs Over Liver, 121 

78. Treating Lower Ribs, 122 

79. Springing Ribs Inward, 123 

80. Emptying the Small Intestine, 124 

81 Manipulating the Intestines, 125 

82. Elevating the Abdominal Contents, 126 

83. Straightening Sigmoid Flexure, 127 

84. Toning Solar Plexus, 130 

85. Treating Spleen or Stomach, 131 

86. Determining Pelvic Lesions, 132 

87. Determining Pelvic Lesions, \ . . 133 

88. Treating the Limbs, 134 

89. Rotating the Leg, 135 

90. Stretching the Sciatic Nerve, 136 

91. Relaxing Muscles Under Knee, 137 

92. Flexing the Foot, 140 

93. Springing the Arch of the Foot, 141 

94. Torsion Treatment of Limb, 142 

95. Setting a Hip Dislocation, 143 

96. Ankle Dislocation, 144 

97. Springing the Knee Joint, 145 

98. Springing the Shoulder Joint, 146 

99. Springing the Elbow Joint, 147 

100. Reducing Shoulder Dislocation, 150 

101. Reducing Elbow Dislocation, 151 

102. Treating Table and Stool, 152 

103. Manipulating Shoulder Joint, 153 

104. Manipulating Shoulder Joint, 154 

105. Stretching Long Head of Biceps, 155 

106. Restoring Respiration, 156 

107. Restoring Respiration, 157 



CONTENTS 

PART I 

Page 
Anatomy, 13 

Examination of Patients, 18 

Prevention of Disease in Girls, 25 

Inflammations of Vulva and Vagina, 31 

Disorders of Menstruation, 34 

Cystocele and Rectocele, 43 

Uterus and Misplacements, 45 

Tumors and Cancer, 57 

Various Inflammations of the Uterus, 60 

Diseases of Ovaries and Fallopian Tubes, 64 

Special Diseases of Women, 65 

Dangers of the Newly Wedded, 98 

Climacteric, 106 

Dangers of Children and Boys, 113 

Dangers of Men Over Forty, 117 

Determination of Sex, 121 

Hov^ to Help Men Keep Marriage Vows, 124 

The Laxus-Cycle, 131 

Obstetrics, 144 

Care of Mother and Child, 151 

PART II 

General Osteopathic Technique, 7 

General Examination and Treatment, 13 

Special Spinal Treatments, 33 

Dorsal Lesions, 46 

Lumbar Lesions, 58 

Sacral Lesions, 67 

11 



12 Contents 

Page 

Coccyx and Its Treatment, 12 

Rectal Treatments, 76 

Rib Treatments, 11 

The Eleventh and Twelfth Ribs with Treatment, 97 

The Abdomen and Treatment, 106 

Consideration of Pelvic Lesions, 109 

Innominate Lesions, 128 

Treatment in General, 159 



OSTEOPATHIC 
GYNECOLOGY 



ANATOMY. 

The organs of generation in the female are divided 
into external and internal by those who classify them 
in such a work as this. We will adhere to the general 
classification. The external organs are known as the 
mons Veneris, the labia majora, labia minora, clitoris, 
meatus urinarius, orifice of the vagina. We frequent- 
ly speak of all these organs as the vulva. 

Mons Veneris is a rounded cushion of fatty tissue 
covering the pubes, which is covered with hair at and 
after puberty. 

Labia Majora and Minora are, as their names in- 
dicate, greater and lesser lips which surround the en- 
trance to the vagina. The lesser lips are the inner 
ones and their internal surfaces have a large number 
of secreting glands. 

The Clitoris is partly hidden by the upper part of 
the inner lips. It is composed of erectile tissue and 
is very sensitive. When this is inhibited it dilates the 
OS, the opening into the cervix of the uterus. This is 
a form of treatment that could be employed when 
there was painful menstruation, due to the contraction 
of the OS, and it may be made use of in the first stages 
of child labor. A sharp pull of the hair on the mons 
Veneris, on the contrary, contracts these muscular 

13 



14 Osteopathic Gynecology 

fibers of the cervix and is used often to prevent an 
abortion or hemorrhage. 

The Hymen is a circular fold at the entrance of 
the vagina, of varying shape, and partially closes that 
organ, sometimes completely, when it is called an im- 
perforate hymen. It would be well to leave such a I 
hymen alone until puberty, when it should be ruptured. 
If there are nervous symptoms manifest before that 
time it might be punctured before. It was formerly 
considered a test of virginity, but as it has been known 
to persist after copulation, and even after childbirth, 
it can no longer be considered as such. On the other 
hand, an entirely virtuous person may have the hymen j 
torn by a variety of causes. 

Bartholin's Glands are found on each side of the 
commencement of the vagina, behind the hymen. 
They are about the size of a large bean, of a reddish 
color, and pour a secretion through two ducts onto the i 
mucous membrane. These ducts sometimes form a I 
lodging place for gonococci and cause pus formation. 
An abscess may be caused in this region by an ex- 
ternal injury. 

The internal organs of generation are the vagina, 
uterus. Fallopian tubes and ovaries. 

The Vagina extends from the vulva to the cervix 
of the uterus. It is about three inches in length and 
capable of great distension, but its walls are generally 
in contact and are composed of muscular, erectile tis- 
sue and have a mucous lining, which furnishes a se- 
cretion that cleanses the vagina. Near the uterus are 
glands which secrete an acid that acts as a bactericidal 



Anatomy 15 

agent in killing germs which otherwise might enter the 
uterus. For this reason one should not use too many 
warm douches, as they tend to wash away this secre- 
tion which kills disease germs, and it also weakens the 
muscular structure which composes and holds in place 
the various organs composing the whole. 

The fornices are formed by the union of the walls 
of the vagina with the cervix, and according to their 
relation with the cervix are known as lateral, posterior 
and anterior. 

The Uterus is a pear-shaped, slightly-flattened 
body about three inches in length, two inches in 
breadth at its largest part, and one inch in thickness. 
It weighs about an ounce and a half. It is located in 
the pelvis, between the bladder and the rectum, with 
the large end, or fundus, upward, with the lower end, 
or cervix, projecting into the vagina. At this lower 
end is an opening called the os, which leads into the 
cavity of the uterus. The uterus varies in size at dif- 
ferent periods of life and after the menopause it be- 
comes very much smaller. The cervix varies very 
much in different individuals. The normal virgin cer- 
vix is smooth and about as hard as your nose. It 
feels to the hand like a rounded cone with a small, 
depressed, round opening. This opening becomes a 
long slit in the cases of those who have been pregnant, 
and an experienced person can determine whether 
there has been a pregnancy. When diseased it is soft 
and patulous, as well as when pregnant. 

The uterus is a very muscular as well as a very 
movable organ. Its fastenings, or ligaments, are very 



16 Osteopathic Gynecology 



if 



elastic, so much so that during pregnancy it ascends jj 
as high as the sternum. It is composed of three coats, 
the largest of which is muscle and as firm as cartilage. 
The outer or serous coat is from the peritoneum, 
while the inner coat is composed of mucous mem- 
brane. There are two upper openings into the uterus 
on opposites sides for the entrance of the Fallopian 
tubes. There are eight ligaments which keep the 
uterus in position, one anterior, one posterior, two lat- ; 
eral, which are often referred to as the broad liga- 
ments, and two sacro-uterine, all of which are formed _ 
from peritoneum. There are also two round liga-1 
ments, composed mostly of muscular structure. All 
of these are capable of being toned up and put in 
splendid condition under manipulation of their nerve ! 
supply. 

The two broad ligaments fasten the uterus to the 
side walls of the pelvis, and each ligament has two 
folds in which are contained the Fallopian tube, round 
ligament, ovary and blood vessels and nerves. They 
prevent lateral displacements of the uterus. The 
round ligaments pass from the uterus, just below the 
entrance of the Fallopian tubes to the mons Veneris. 
The anterior ligament, vesico uterine, passes from the 
center of the uterus in front to the bladder. The 
posterior or recto-uterine ligament passes from the 
uterus to the sacrum and rectum and forms the pouch 
of Douglas. The sacro-uterine ligaments are at- 
tached to the second and third bones of the sacrum , 
and to each side of the uterus about its middle. 

The Ovaries are two almond-shaped bodies] 



Anatomy 17 

weighing about one and a half drachms, one and a 
half inches long, three-fourths of an inch wide and 
one-third of an inch thick. They are fastened to the 
uterus by the ovarian ligament about an inch in length, 
and therefore whenever the uterus is out of position 
there is a corresponding displacement of the ovary. 
The ovaries are underneath the Fallopian tubes, which 
form a loop around them and are closely held by the 
fimbriated extremities of the tubes. When the ovaries 
are removed the rest -of the generative organs become 
atrophied and functionally valueless. They corre- 
spond to the testes in the male and become much 
smaller after the menopause. The ovary matures the 
ova and when they are destroyed menstruation ceases. 
For this reason every effort should be made to save 
them. 

The Fallopian Tubes are four inches long and are 
for the purpose of conveying the ova to the uterus. 
The opening into the uterus is very small, about the 
size of a fine bristle, while the one into the abdominal 
cavity is larger. When the tube is diseased it fails to 
carry the ova to the uterus, or if so, very slowly, and 
then we have a case of tubal pregnancy. 



18 Osteopathic Gynecology 



EXAMINATION OF THE PATIENT. 

One could hardly do better in outlining the exami- 
nation of the patient than to give his own method of 
procedure; a method that grew simpler as the years 
went by, yet was attended by more satisfactory re- 
sults. I do not believe that it is necessary, in a great 
majority of cases, to subject the patient to a long and 
tedious examination in which instruments are used, 
and the methods of inspection, in vogue with a great 
many, are employed. 

My reception room was large, well lighted and kept 
very clean. Everything about it was bright and cheer- 
ful. The furniture was mission style and the hard- 
wood floors were well covered with bright-colored 
rugs. It was not flashy, but not too somber. A large 
fern was placed at one window. There were plenty 
of rockers. There was a good supply of up-to-date, 
popular literature, including some bearing on my own 
specialty. The bookcases were sectional and the lat- 
est medical works were in them. 

There were four good-sized treating rooms in con- 
nection with the reception room, which contained a 
treating table, costumer, dresser with mirror attached, 
and a couch on which many of the patients rested and 
perhaps took a short nap after the treatment. The 
offices were well supplied with full-length and full- 
fashioned kimonos, which the patients donned for the 
treatment. It took a great number of them so that 
they could be kept clean. In the treating rooms were 



Examination of the Patient 19 

running water and a plentiful supply of towels and 
soap. The hands were cleansed before and after 
treatment. 

My best asset was a nurse of mature years, kindly 
and pleasant, not much given to talk, but who easily 
won the confidence of the patients by her genuine in- 
terest in their case. Her assistance was invaluable in 
the cases of those who were young and timid. She 
helped them prepare for treatment and, if it were the 
first visit, told them just what to do. They often told 
her things which they would be slow in telling a man. 
Many were held for the treatment who otherwise 
would have lost its benefit. There are those who do 
not wish to bring a friend or relative for company 
during examination, not caring to have them know 
the extent of their affliction. To such a nurse is a 
real help. In case she was not otherwise engaged she 
would meet the regular patients in the reception room 
and assign them to a treating room, helping them 
when necessary. Her presence kept me from being 
bothered wnth a certain class who knew that the office 
was being supported solely for the benefit of those 
who stood in need of medical treatment. 

The back of a patient who came for the first time 
for gynecological examination was thoroughly pal- 
pated for the purpose of finding all deviations from 
the normal. It was tested in all ways as told in the 
chapter describing a general examination. Many per- 
sons who are treated for diseases peculiar to women 
have other ailments, and they will not receive the ex- 
pected relief until these other weaknesses are correct- 



20 Osteopathic Gynecology 

ed. For some time they might receive needed correct- 
ive treatment in the back before any local examina- 
tion was attempted, and perhaps they might entirely 
recover without such examination on correction of all 
lesions found. When you first see the patient let her 
talk considerably. Encourage her to tell all of her 
troubles. Learn the age, whether married or single; 
how many children and when born; miscarriages and 
when ; all about her various labors and their character. 
Has she headache and where? Backache and its se- 
verity. Questions should be asked that would throw 
light on the condition of the heart, lungs, kidneys, 
liver and stomach. If she has had a pain or ache, 
learn when it started and what she was then doing. 
Ask concerning the menses. Learn as to any irregu- 
larity in time or in the amount of the flow, and wheth- 
er there is any pain. Pain occurring before the flow 
indicates ovarian disease. Pain during the flow in- 
flammation of the endometrium, and if pain ceases on 
the beginning of the flow we think of an obstruction 
of some kind. Inquire about micturition and all 
vaginal discharges. A thick discharge with an offen- 
sive odor indicates badly diseased conditions. If you 
can get the patient to talk freely she will tell you a 
great deal without asking many questions. Some- 
times I had patients who wished me to tell just what 
the trouble was without asking any questions. More 
of them did this because a man in the same town made 
a point of diagosing without questions. But I told 
them that it was difficult enough to diagnose when you 
were acquainted with all the facts at hand. One day 



Examination of the Patient 21 

a lady came to me greatly terrified. She had had her 
case diagosed by a man who held her hand and with 
the other hand he held a Bible and pretended to feel 
her pain. He informed her that one kidney was near- 
ly gone, but he failed to tell her of an acute pain 
which was in one knee. On examination of the urine 
I found the kidneys to be perfectly normal. Always 
make a point of examining the urine. 

Examination of the Abdomen. Have the under- 
wear removed and the kimono so worn that the ab- 
domen can be fully exposed. The general outline of 
it will be noted as well as the size, and any enlarge- 
ment, such as tumors or fat, may be determined, the 
former appearing prominent in one place and the lat- 
ter being more symmetrical. The umbilicus is con- 
cave and the abdomen flat around it in the normal 
condition; but if there be much gas, or the abdomen 
is distended with ascites, the umbilicus is flattened. In 
palpating the abdomen the patient should lie on the 
back with the knees flexed. The hand of the operator 
should be warmed in water and gentle pressure used 
at first, after which it may be gradually insinuated 
deeper into the tissues, and all displacements, irregu- 
larities, impactions and tenderness noted. When the 
abdominal walls in any place are tender and con- 
tracted the viscera underneath are diseased and in- 
flamed, because the viscera and the integument have 
the same nerve supply. See Hilton's ''Rest and Pain.'' 
See part 2 on The Abdomen. 

If there is tenderness on pressure just above the 
pubic bones we would think of cystitis and inflamma- 



22 Osteopathic Gynecology 

tion of the uterus, while tenderness in right or left 
side of the abdomen below the umbilicus might indi- 
cate disease of the tubes and ovaries. We cannot be 
too certain in making a diagnosis of tumor when lo- 
cated in the abdomen. The fifth lumbar vertebra, in 
thin persons, may be mistaken for a tumor. When 
pressure is exerted on the iliac artery it may be taken 
for a pulsating tumor. Fecal impactions, pockets of 
gas, are frequently mistaken for tumors requiring an 
operation. I examined a wealthy patient who had 
been told that she had a tumor requiring the use of 
the knife. I use the term ** wealthy," for I fear that 
the possession of wealth sometimes calls for an opera- 
tion with some doctors. She had an intestinal indi- 
gestion Wjhich caused an accumulation of gas. She 
was relieved of her trouble in about two weeks. The 
doctor who diagnosed her trouble said afterwards that 
tumors sometimes disappeared themselves. They do, 
but not in two weeks, when as large as croquet balls. 
The temperature is important. If the lower part of 
the abdomen is colder than the upper part there is quite 
likely some pelvic trouble. A lower temperature any- 
where is indicative of poor circulation and a weakness 
in the organs under the cool region. 

Vaginal Examination should not be made in ev- 
ery case. Many physicians do so on the slightest ex- 
cuse and often cause injury to the patient. It may be 
more frequently done in case a woman has reached 
the climacteric when we are fearful that there may be 
cancer. When necessary to make a vaginal examina- 
tion place the patient in the Sims position, lying on the 



Examination of the Patient 23 

left side, pretty well turned to the front, with the 
limbs flexed. Have the forefinger of the right hand 
lubricated with vaseline, introduce under the kimono 
from behind and into the vagina, avoiding the clitoris. 
This examination need not take more than one minute, 
and the following points should be noticed: The tone 
of the pelvic floor, size and tenderness of the vaginal 
orifice, the condition of the walls and rugae, the secre- 
tions and temperature. Foreign bodies, if any, are 
noted, and tumors, which are sometimes mistakenly 
noted as such when there are feces in the rectum. 
The cervix is carefully examined, whether of natural 
size or of an infantile character; whether there is a 
flexion or version of the uterus. What is the size 
and shape of the os? Whether the cervix is soft or 
patulous, and if the uterus is freely movable. You 

. may tell whether there is any congestion or inflamma- 
tion in the tubes or ovaries. Pressure causes consid- 
erable pain in a diseased ovary. The fornices may be 
examined for any abnormality. 

Bimanual Examination. The patient lies on the 
back, with the heels about one foot apart, and the 
forefinger is introduced into the vagina, or rectum^ 
and the left hand is used in palpating the abdomen. 
We may thus hold the uterus between the two hands 
and discover its size, shape and position. The patient 
may turn on the back while the operator still holds his 
finger in the vagina, if he has been examining in the 
Sims position. If all the information necessary has 
not been obtained, in cases where there is inflamma- 
tion of the vagina or uterus, or the patient is a young 



24 



Osteopathic Gynecology 



girl, the finger of the right hand should be introduced 
into the rectum. Any growth of an abnormal nature 
may be found in this manner and a diagnosis made in 
any other manner may be confirmed. 

There are various instruments in use, but they are 
seldom If ever needed: the Sims and bivalve specu- 
lum, various sounds and probes, also electric-lighted 
mstruments, which impress the patient but are not of 
any real value and often cause injury. Some of the 
authors cases, which had resisted the treatment of 
emment specialists and were completely cured by the 
removal of simple spinal lesions, were examined only 
once and then very simply. It was not necessary to 
use the bimanual method in many cases 

Pelvic Examination. Use inspection and note 
whether one crest of one innominate bone is higher 
than the other. This may be determined by placing 
each hand on the crests and noting their relative dis 
tance from the table upon which the patient is seated 
Note whether one posterior spine of the ilia is higher 
or more prominent than the other. Note if there is 
tenderness about one or the other. The waist lines 
should be compared, and note whether one limb is 
longer than the other. This is seen while the patient 
IS in the reclining position, and one can determine 
whether the anterior superior spines of the ilia are of 
one height and whether there is tenderness in either 
Note any tender spots along the spine and see in the 
second part of this book "The Examination of the 
Pelvis. 



Prevention of Disease in Girls 25 



PREVENTION OF DISEASE IN GIRLS. 

Preventive medicine is becoming recognized as the 
highest type of therapeutical knowledge. To keep 
our patients well is far better than ability to cure them 
when ill. 

This is doubly true with respect to the nerve-de- 
stroying, devitalizing diseases and weaknesses peculiar 
to women. It is very desirable that a knowledge of 
how to prevent the ills that beset them should be in 
the possession of every woman, for ignorance and 
carelessness lie at the root of most of the ills of wom- 
ankind. 

A knowledge of physiological laws, which really 
should be well known in this day of enlightenment, 
and an abatement of practices that run counter to 
these laws of nature, will do much to preserve women 
in the health, strength and beauty which naturally be- 
long to them. A strong, healthy womanhood means 
much for the future well-being and happiness, not 
only of the individual, but of the race. 

Heredity plays an important part in transmitting 
weakness which predisposes to diseases having their 
seat in the pelvic region. This can be largely over- 
come if we make the best of what we have in the way 
of health and strength. Then, by paying proper at- 
tention to the laws of nature, better bodies will be 
transmitted to our successors. 

School. The starting point of many of the weak- 
nesses that predispose to pelvic diseases in women 



26 Osteopathic Gynecology 

is in the schoolroom. Too frequently the desk is not 
adapted to the pupil. The seat, or desk, is either too 
high or too low, or the desk is not properly placed 
with reference to the seat. The seat should fit the 
child. The feet should reach and rest on the floor in 
all cases, yet the seat should not be too low, as this 
tends to a posterior position of the lower part of the 
back. The back is thrown back in the lumbar region 
by having the knees too high. The same effect on the 
spine will be caused by a low desk. This necessitates 
bending forward by the pupil to study. When this 
position is assumed day after day for several hours 
at a time the spine begins to take on an abnormal 
curve. This weakens the nerves which supply the 
pelvic region, coming as they do mainly from the lum- 
bar portion of the spine. The circulation is impeded 
and disease begins its work. 

The desk should be so placed and of such a height 
that when the pupil is erect a book placed thereon will 
be from twelve to fourteen inches from the eyes. The 
slope of the desk should be about ten or twelve de- 
grees. An adjustable seat and back rest, as is used 
in the public schools of Boston, would be advanta- 
geous. No child should occupy a seat in school for 
any length of time that compels the taking of a faulty 
position in any of the required work. When the desk 
is too high a curvature of the upper dorsal region 
of the spine will be manifest while the pupil is en- 
gaged in writing. 

The heat and ventilation of many schools are far 
from being ideal. Many schools maintain a tempera- 



Prevention of Disease in Girls 27 

ture far too high and the ventilation is very deficient. 
It would be better for the pupils to wear their wraps 
if necessary and have the benefit of studying in cool- 
er rooms with plenty of air. They soon tire in the 
heat and foul air and assume improper positions, be- 
cause the muscles have lost their tone, as they do when 
we are tired from any cause. This lowers the vitality 
of the whole system. 

Length of Hours. We are not alone in claiming 
that between the ages of twelve and sixteen girls should 
not study more than four hours a day. There should 
be both bodily and mental rest and plenty of it. The 
organs of regeneration up to this time have been dor- 
mant. The body has been developing along other 
lines. Now there comes a change. The organs be- 
come more vascular, the nerves are more active. The 
physiological function of ovulation and menstruation 
begins. That the developing of these organs may pro- 
ceed properly the nourishment — in other words, the 
nerve and blood supply — must be increased, as it is 
under normal conditions. 

If, however, the girl is entering keenly into all the 
school work of the present day, using all her energy 
to get to the front and hold her position there, taking 
part in rivalries and competitions, she is using 
strength that should go to the development of the pel- 
vic organs. The same is true if hard work is being 
performed in the home or factory. This is the cause 
of many an undeveloped or infantile uterus. The 
troubles of many women begin when menstruation 
first appears. The fault, if traced back, will be found 



28 Osteopathic Gynecology 

to have been caused by overwork of some kind result- 
ing in improper development and weakness. This 
lack of strength may have been in the pelvic tissues 
surrounding the uterus, resulting in relaxed ligaments 
which allowed the organ to assume some of the many 
malpositions common to weakened conditions in this 
region. 

Late Hours. Late and irregular hours are often 
kept by girls, and are very detrimental to their health. 
At least eight hours of sleep are needed. This should 
be had regularly, and the custom of breaking into it 
for social diversions of various kinds is to be depre- 
cated. Here we might take occasion to say that enter- 
tainments which produce emotional disturbances at 
this period in life have been the cause of sexual weak- 
ness. Anything that produces a drain on the nerves, 
even if it be a protracted religious revival service, 
tends to the same end. 

Bad Books. The reading of books that are sen- 
sual in their suggestiveness, looking at pictures of the 
same nature, or any personal evil communications that 
tend to inflame the passions are not to be counte- 
nanced. They cause an active or passive hyperemia, 
or congestion of the blood, in the pelvic regions. 
While they undermine the moral character they tend 
to deterioration of the physical. 

Exercise. We do not wish it understood from 
the foregoing that girlhood should be a period of idle- 
ness. There should be enough of physical work of 
some nature for sufficient exercise. One can study 
better after exercise if it has not been too violent. 



Prevention of Disease In Girls 29 

The exercise should be taken regularly and should be 
adapted to the needs of the individual. It should be 
so regulated as to build up the entire body. 

Good Food. There should be an abundance of 
nourishing food. It would be better to have a plain, 
wholesome diet. Rich food with spices, sauces and 
condiments should be avoided. Fried foods, and a 
great deal of pastry, cakes and pickles will be better 
for the stomach and general health if left out of the 
menu. I have had occasion to notice in a number of 
instances where girls, who did not have the best of 
health at home, on going to good boarding schools im- 
proved rapidly and went home in the best of health. 
The reason could be attributed to regular, seasonable 
hours, systematic exercise and proper food. 

Menstruation. As each monthly period ap- 
proaches there should be a cessation of the strenuous 
life. There should be no overwork or extra endeavor, 
either mental or physical. Neglect during the men- 
strual period is a fruitful source of female difficulties. 
Exercises or games which are somewhat violent in 
their nature, as basketball, tennis, horseback riding, 
dancing, skating, etc., should be omitted. Sexual in- 
tercourse should be absolutely prohibited during the 
period. There is blood enough in the pelvic region, 
and further congestion, as caused by coition, leads to 
tumors, metritis, leucorrhea and other diseases. 

Constipation. The lack of attention to the calls 
of nature is a frequent cause for constipation. The 
feces accumulate in the bowels and by direct pressure 
interfere with the pelvic circulation and force the 



30 Osteopathic Gynecology 

uterus out of its normal position. They also give rise 
to the gases and toxic substances which are absorbed 
and cause headache, neuralgia, and diseased blood. 
The urine should be voided when necessary. When 
retained too long it may be a cause of inflammation of 
the bladder or paralysis of the organ itself. It may 
also be a cause of uterine disease, because it tends to 
push the uterus backward out of place and interfer- 
ence with normal circulation. 

Dress. Any garment that causes undue pressure 
on the abdomen and constricts the waist line is a men- 
ace to a woman's health. The abdominal walls are 
frequently weakened and their contents forced down- 
ward toward the pelvic floor, obstructing the circula- 
tion in this region. 

Corsets frequently cause more trouble by pressure 
on the abdomen than by pressure exerted over the 
chest. The pelvic floor is weakened, and this allows the 
pelvic organs to be forced out of position. Any mode 
of dressing that leaves any portion of the body unpro- 
tected, forcing the blood away from the surface to the 
interior, frequently is a cause of pelvic congestion. 

Many cases of female weakness may be traced to 
high-heeled shoes. Girls should never be allowed to 
wear them. The bones, ligaments and muscles are 
not fully developed and the joints are easily changed. 
The pelvis is tipped and abnormalties of the spine fol- 
low, which, as we shall see later, lead to weakness of 
the pelvic organs. 



Vulvitis and Vaginitis 31 



VULVITIS AND VAGINITIS. 

Vulvitis is an inflammation of the vulva, and in 
this connection we will treat of Vaginitis, an inflam- 
mation of the vagina. Both may be caused by a 
lesion of the spine in the lumbar or sacral region, 
causing a stagnation of the blood. An innominate 
out of place would also act as a cause. These diseases 
may be caused by continuity of tissue; that is, mal- 
positions and inflammations of the uterus, causing 
vaginitis, and this in turn may be the cause of vulvitis ; 
uncleanliness and accumulations of smegma following 
menstruations, discharges and loss of the normal 
vaginal secretions, which allow actions of germs of a 
pathogenic nature. Trauma, attempted abortion and 
bungling coitus are causes. There may be gonorrheal 
infection, causing more intense symptoms, which in 
many cases is a cause of chronic inflammation. This 
frequently leads to the death of the patient, after 
operations, and causes untold misery. This is because 
the infection enters the uterus, tubes, and in some 
cases the abdominal cavity. The symptoms of in- 
flammation are heat, pain, redness, swelling and loss 
of function, and these symptoms are present in these 
diseases. In the specific cases the symptoms are much 
the same as in the simple forms, but much more se- 
vere. The parts are very hot and dry at first, which 
condition gives way to a muco-purulent yellowish, 
thick discharge after a few days. The patient feels 
bad and there is some fever. In fact, the symptoms 



32 Osteopathic Gynecology 

are of a varying nature. We will not expect to find 
them all present in simple cases, and in some cases 
of gonorrhea they are worse. The treatment is best 
applied by removing all causes. 

Lesions of all natures found in the dorsal, lumbar 
and sacral regions, as well as those found in the pelvic 
region, should be removed as soon as possible. The 
parts should be kept very clean and a mild boracic acid 
solution may be used. If the case is a severe one rest 
by being perfectly quiet. This prevents irritation by 
friction. In cases caused by gonorrheal infection use 
a rose-colored solution of permanganate of potassium. 
Care should be taken to prevent the spreading of the 
infection while taking a douche. In the simple cases a 
good douche is warm water at about 110 degrees F., 
with a tablespoonful of salt to a quart of water. 

Puritus Vulvae is a very great itching of the re- 
gions affected. This is often caused by pressure on 
the spinal end of nerves that supply the vulva. Dirt, 
worms, lice, kidney diseases and masturbation act as 
causes. It comes on during pregnancy and at the 
change of life. When possible remove the cause. A 
two per cent carbolic acid poultice gives relief. Apply 
cod liver oil to the part. Lesions in the lumbar and 
sacral regions should be looked for in some cases. 

Vaginismus is a rare disease. The nerves are ir- 
ritated, which cause the muscles of the pelvic floor, 
vagina, and about the entrance of the vagina to be vio- 
lently and spasmodically contracted. It is a disease of 
young married women, though I have found it in the 
case of unmarried women past the menopause. A lo- 



I 



Vulvitis and Vaginitis 33 

cal examination or coitus is impossible. When the 
case is not fully developed coitus is abhorrent A ten- 
der ovary, a displaced coccyx, vaginitis, pelvic inflam- 
mation and lesions of the lumbar and sacral regions 
act as causes. These cases do not get better unless 
treated; and we expect a cure under Osteopathic 
treatment. As a palliative treatment one writer rec- 
ommends applying a pledget of cotton containing a ten 
per cent solution of cocaine to the vaginal orifice for 
ten minutes before coitus. Immediately after remov- 
ing the pledget of cotton apply vaseline to the parts. 
Surgeons cut and sever the muscles. In all cases of 
vaginal disturbances look for some anatomical abnor- 
mality. Use as few douches as possible and then for 
cleansing the parts and not as a curative agent. 



34 Osteopathic Gynecology 



MENSTRUATION. 

Menstruation is a discharge of blood from the 
uterus and Fallopian tubes that occurs every twenty- 
eight days from the time of puberty to the meno- 
pause. It is a very natural process and it is a wise 
provision of Nature which prepares the way for the 
reproduction of the species. In those who have a well- 
developed sexual, passion it appears earlier than those 
who have a weak sexual instinct. 

There are certain signs present before the flow be- 
gins that are partly the result of congestion which in- 
terferes with the function of some nerves, causing re- 
flex disturbances. The pelvis and limbs feel heavy as 
a result of this congestion. The thyroid gland, the 
swelling of which we call goitre, and the throat in 
general become congested so that the voice is affected. 
The breasts are swollen and tender and the face may 
become pigmented. The nervous changes with many 
are very noticeable. There is a lack of energy and an 
increase of leucorrhea in amount. There is headache 
and backache and the entire body seems tender and 
sore. The flow varies in the case of different individ- 
uals. It may be as short as two days in length, or it 
may last six days and be entirely normal, but the gen- 
eral time is about four days. When the patient is en- 
tirely w^ell it may be that this period will be free from 
pain. This is the ideal condition. However, we do 
not often find a woman but that has some trouble at 
the menstrual time. 



Menstruation 35 

There may be no menses at all, or they may be 
scanty, or there may be too much of a flow, or it may 
be painful. It is also suppressed or irregular or it 
may begin too early. It may sometimes flow from 
other parts of the body, and it is- then called vicarious 
menstruation. 

When there is absence of menstfuation in a woman 
who is sexually mature it may be caused by a faulty 
formation of the sexual organs, but this is not often 
the case ; or it may be the result of their imperfect de- 
velopment. Many cases are caused by diseases which 
greatly weaken the system ; as typhoid fever, scarlet 
fever, tuberculosis, Bright's disease and diabetes. It 
may be caused by great excitement, fright or excessive 
joy. Lesions of the spine, w^hich affect the ovaries, 
are also a cause. These lesions are found in the dor- 
sal region, and the spine is often smooth, stiff and 
straight, with an occasional twisted or displaced lower 
rib. These lesions would operate by interfering with 
the nerve supply of the ovaries, and they in turn affect 
the whole of the pelvic organs. 

The symptoms of amenorrhea, or lack of the men- 
strual function, vary in different cases. With some, 
who have been overworking, either by study or man- 
ual labor, the symptoms may not amount to much. 
The blood has been used in building up brain and 
muscle and there is not enough left to start menstrua- 
tion or to affect the pelvic organs, so there are not 
any unusual symptoms. But others, who have been 
leading a more normal life, and who have more blood, 
will have hot and cold flashes, stomach troubles, pain 



36 Osteopathic Gynecology ^ 

in the abdomen, nervous disorders, headache, and oth- 
er symptoms of menstruation without the flow. We 
would expect an " infantile '' uterus, or atresia, or an 
imperforate hymen. There may be some lesion of the 
dorsal or lumbar region of the spine that would cause 
the undeveloped condition of the pelvic organs. 

Where the function has been established and has 
stopped afterwards for any cause the symptoms also 
vary greatly. In some there is almost a complete ab- 
sence, and in others they are very marked. They have 
the regular symptoms of menstruation without the 
flow most of the time, and at the time when they ought 
to flow the pain and discomfort are greatly intensified. 
If they have distension of the abdomen, accompanied 
by general loss of strength, it may be that the flow is 
concealed and still remains in the uterus, and after re- 
maining for a few months will be discharged in large 
quantities and will be found to be clotted and black. 
A physician must be on his guard with such cases At 
one time the author had a patient, who was honest in 
every particular, bring to his office another who had 
not had the menses for five months. She was very 
large in the lower abdomen and claimed a physician 
had been treating her for a rapidly-growing tumor for 
some time. I thought it rather peculiar, and being 
very busy set a time for an examination. The patient 
did not appear at the appointed time, but about four 
months afterward she gave birth to a child. 

So we see it is very important that the correct diag- 
nosis in all cases should be made. Whether the 
amenorrhea is the result of some weakened condition, 



Menstruation 37 

or due to pregnancy, may be determined by the usual 
signs of pregnancy which are presumed to be, in addi- 
tion to the stopping of the menses, morning sickness 
and an irritable bladder, nervous changes and more in- 
clination to hysteria. The most probable signs are 
changes in the mammary glands, uterus and abdomen ; 
the nipples becoming softer and larger and the skin 
about them becoming darker in color. The abdomen 
and uterus grow progressively larger and the cervix 
becomes softer about the second month. The position 
of the uterus changes, first dropping forward and then 
rising. The positive signs of pregnancy do not ap- 
pear until about the twentieth week, and they are fetal 
heart beat, ballottement and quickening. The fetal 
heart beat is about twice that of an adult and may be 
heard by applying the ear to the abdomen of the preg- 
nant woman. Ballottement is performed by moving 
the child in the uterus from one side of the abdomen 
to the other. The quickening is noted by the mother 
and the feeling has been said to be like the " fluttering 
of a bird in the hand.'' One should be very careful 
of a wrong diagnosis, as it would be a source of great 
mortification to the one making the examination and 
might cause the patient considerable harm. If there 
are signs that Nature is attempting to bring about 
menstruation, and these signs are occurring every 
fourth week, we may rest assured that the stopping of 
the menses is unnatural and pathological and that we 
should assist Nature by giving a treatment to reestab- 
lish the function. This may be done by using para- 
graphs 43, 44, 47, 48, 49, 50, 51, 52, 57, 58, 59, 68. 



38 Osteopathic Gynecology 

Considerable work may be done in the lumbar and 
sacral portions of the spine, and in connection with 
this I would give a general treatment (which see). 
On the other hand should the patient be found preg- 
nant such a treatment would be injurious. Should a 
menstruation be suddenly stopped on account of a 
cold or getting the shoes wet, or wading in water, or 
by fright, we will find the muscles very tense in the 
lumbar and sacral regions. These should be relaxed 
in a very thorough manner, using the manipulations 
as found in paragraphs No. 57, 59, 60, 47, 48, 43. 
Considerable work may be done over the uterus, 
through the abdomen, thus relaxing the muscles of the 
uterus. See paragraphs No. 94 to 103. 

In case the flow has stopped on account of poor 
health, and as a consequence the patient has poor 
blood and very little of that, it would be poor policy to 
bring on the flow by treatment. The best thing to do 
would be to build up the health, and to do that we 
would increase the blood and make it richer and bet- 
ter. This would be done by correcting lesions that 
affect the vital organs, and having a diet that would 
make better blood. We would advise plenty of water 
to be taken at regular intervals, plenty of sleep, lots 
of good air and manual manipulations. 

If the amenorrhea is due to smallness and lack of 
development of the organs the fault is often found in 
the lower dorsal and lumbar spine. There are lesions 
there which interfere with the nerve force or supply 
of the ovaries. The ovaries are not properly devel- 
oped, and these organs control the function and ac- 



Menstruation 39 

tivity of the other pelvic organs. By increasing the 
size and activity of the ovaries, through giving them 
a better nerve and blood supply, wt help the other 
pelvic organs. Often the spine is stiff and the verte- 
brae too close together. This is remedied by springing 
the spine, as in paragraphs No. 57, 64. Also we should 
remove all muscular lesions present. See paragraphs 
No. 58, 59, 60. 

Menorrhagia is a term used to denote a flow^, men- 
strual in character, which is so profuse as to weaken 
the patient ; and she does not recover until she has the 
menstrual period again. This excessive flow is often 
caused by a soft and relaxed condition of the uterus. 
The inner or middle muscular wall of that organ is 
made up of fibers that act as ligatures on the blood 
vessels. These fibers, when relaxed, allow the blood 
vessels to pour out their contents. When this is ac- 
companied by a lack of power of the blood to form 
clots, which act to stop the flow, the hemorrhage is 
greater. If there be a congested condition of the 
uterus it will increase the trouble. The treatment 
should, of course, attempt to remove the cause. 
Should the patient be suffering with any blood disease 
or any trouble that interferes with its coagulability, 
that should have especial attention. The author has 
had cases that would not respond to any other form 
of treatment than the manual. The lesions that we 
find to be most frequent in cases of this kind are back- 
ward twists of the innominate bone. This is usually 
the case when one leg on that side is found to be the 
shorter of the two. This causes a relaxation of the 



40 Osteopathic Gynecology 

muscles and of the blood vessels, and is responsible 
for congestion causing the hemorrhage. Another 
cause of menorrhagia is the growth of fibroid tumors. 
Frequently we discover that we have the tumors when 
we are treated for the menorrhagia. The tumors are 
responsible for the congested condition that caused the 
flow, but back of this is the lesion responsible for it 
all. The idea in the treatment is to have the feet high- 
er than the head. Elevate the foot of the bed about 
two inches. Keep the patient from excitement and 
worry. Visitors are out of place. Give a strong treat- 
ment in the lower lumbar and sacral regions. See 
Nos. 68, 69, 48, 51, 57. It would be well to give this 
treatment each day until the patient is better; then 
every other day for a while and once per week for 
some time. 

Dysmenorrhea, or painful menstruation, includes 
painful symptoms referred to th^ pelvis at or near the 
time of menstruation. Should there be pain for from 
three to seven days before the flow we refer the pain 
to the ovaries. If the pain comes on just preceding 
the flow it is caused by obstruction and may be due to 
flexion of the uterus. Should the pain only accom- 
pany the flow and c6ntinue until its close it is caused 
by inflammation. Should it begin just before the flow 
and continue through it, we conclude that it was 
caused by inflammation and obstruction, and if it be- 
gan some time before we would conclude that there 
was ovarian trouble in addition. We may give very 
quick relief in these cases by thoroughly loosening the 



Menstruation 41 

muscular structures in the lower lumbar and dorsal 
region. See Nos. 47, 48, 49, 51, 52, 57. 

We do not find the obstructive form alone very 
often, but it is accompanied by inflammation. It is 
often caused by anteflexion of the uterus. The blood 
vessels are obstructed. The uterine walls are brought 
closely together and the blood is clotted, as it is com- 
pelled to remain in the cavity of the uterus until 
uterine contractions are excited, which cause the pain. 
The uterus should be placed in proper position, and it 
will be necessary to do this often, for we must remem- 
ber that we have a muscle to deal with and it will take 
it some time to conform to its new or proper position. 
At the same time the nerve supply must be corrected, 
which may be done by correcting all bony lesions. 
See Nos. 104 to 109; also the paragraphs referring 
to the treatment of the lower dorsal and lumbar re- 
gions of the spine. In case the painful menstruation 
should be caused by an undeveloped or infantile ute- 
rus in obstructing the flow, such a uterus may be de- 
veloped by a prolonged course of treatment. Such 
treatment presupposes lesions in the lower dorsal, lum- 
bar, and sacral regions of the spine. See Nos. 47 to 
57. In nearly all cases of those who have not borne 
children we expect faulty development to be at the 
bottom of their painful menstruation. Marriage and 
the rearing of children are a remedy for this trouble. 

In treating these cases of dysmenorrhea we would 
examine carefully the dorsal and lumbar regions of 
the spine; the lower dorsal in case there is trouble 
with the ovaries. The lesions of the lower rib. 



42 Osteopathic Gynecology 

especially, pressing downward upon an intercostal 
nerve, affect the circulation of the blood, which affects 
the ovaries. These must be corrected and the muscles 
relaxed which keep these ribs in an improper position. 
So long as a cause for disease exists we can not expect 
a cure. See Nos. 90 to 93. It is also of advantage to 
lift up the intestines. They frequently obstruct the 
return flow of blood from the uterus and ovaries and 
cause neuralgia or colic. See Nos. 96 to 97. When 
there is an anteflexion of the uterus we may some- 
times correct it by working deeply over the uterus. 
To do this properly have the hips elevated and work 
on the abdomen, w^ith force, from the pubes upward, 
using the flat of the hand and not the tips of the fin- 
gers. See Nos. 94 to 103. 

In these cases it is well to look after the general 
health. The appetite is frequently poor and the pa- 
tient should be encouraged to take a little nourishing 
food between meals and before bedtime; a cup of 
milk or beef broth. Sleep, at least eight hours, is 
necessary, and plenty of exercise and fresh air be- 
tween the periods should be had. At the time of the 
flow it is well to rest in bed. The bowels should be 
well looked after; the movements should be regular. 
In constipation the ligaments bind the vertebrae too 
close together and there is often a posterior condition 
of the lowxr dorsal and lumbar regions of the spine. 
To correct this see paragraphs No. 43, 44, 48, 49, 
51, 63. Relax the muscles of the lower part of the 
back. See paragraphs No. 47, 53, 58, 64. Raise the 
lower ribs. See Nos. 90 to 92. The bowels may be 



Cystocele 43 

manipulated. See paragraphs No. 94 to 100. Have a 
regular time to go to stool and do not neglect the calls 
of Nature. 

The pain may be greatly relieved by the use of hot 
water bags or hot sand bags applied externally. A hot 
water foot bath will be helpful in which a tablespoon- 
ful of mustard is placed to a foot-tubful of water. 

CYSTOCELE. 

Cystocele is a protrusion of the bladder into the 
vaginal canal, due to an eversion of the anterior vagi- 
nal wall. It is a disease of women who have borne 
children. The vaginal wall, which is a support of the 
bladder, is greatly weakened during childbirth, it be- 
ing stretched so much that its tone is lost and a dis- 
tended bladder is forced downward into the canal. A 
frequent desire to micturate is the chief symptom of 
this trouble, and when urine is passed there is still 
some left in the bladder which may set up cystitis. 
When the urine is not voided often the parts feel as 
though there might be a prolapsus of the uterus. In 
fact, there is an occasional prolapsus of the vagina and 
uterus, complicating this trouble. In treating this 
disease remove the pressure on the vaginal wall by 
frequently emptying the bladder. The bladder may 
be lifted up, using a sound in the urethra. We find le- 
sions in the lumbar and sacral regions which weaken 
the supports of the bladder. The walls of the vagina 
are enervated from this region. Use strong stimula- 
tion over the sacrum and this wull increase the nerve 



44 Osteopathic Gynecology 

force, or supply of the supporting muscles. A muscle 
is always weak when its nerve supply is poor. See 
paragraphs No. 51, 52, 57, 58. Occasonally use the 
finger to smooth out the walls of the vagina. 

Rectocele is a trouble caused by the rectum dis- 
tending into the canal of the vagina. It is frequently 
caused by childbirth when the attachments that unite 
the rectum and the levator ani muscles are separated 
and the result is rectocele. Constipation tends to pro- 
duce this trouble, and is associated with hemorrhoids. 
The treatment would be the same as for cystocele, 
with added treatment for constipation (which see). 



The Uterus 45 



THE UTERUS. 



The Uterus when normal is freely movable and 
hangs suspended by muscles, which are called liga- 
ments, in the pelvis, with its fundus at about the brim, 
and points toward the umbilicus with its cervix pro- 
truding into the vagina at about right angles with that 
organ. The cervix points toward the last sacral verte- 
bra. The uterus is pushed backward by a distended 
bladder and forward by an impacted rectum. It rests 
on the pelvic floor and is pressed down by the intra- 
abdominal pressure from above. Its position should 
not be regarded as abnormal, though away from the 
normal, when it does not cause any discomfort. When 
it gives the patient no trouble it should be left alone. 
The uterus is supported, in large part, by the pelvic 
floor of which its ligaments are a part. 

The round ligament prevents backward displace- 
ment of the body of the uterus, while backward dis- 
placement of the cervix is prevented by the utero- 
vesical ligaments. It is kept from forward and down- 
ward displacements by the sacro-uterine ligaments, 
while the broad ligaments tend to keep it from lateral 
malpositions. These ligaments are in a slightly re- 
laxed condition and allow some freedom of motion 
which the normal uterus has. When the uterus is en- 
larged and relaxed, or does not properly become nor- 
mal in size after childbirth, the ligaments will be flab- 
by and allow the uterus to move too freely. These 
ligaments are toned up by the treatment of the spine 



46 Osteopathic Gynecology 

and correcting abnormalities of the peh'ic bones. This 
gives the proper nerve force to the hgaments and re- 
sults in their permanent strengthening. Thus the 
Osteopath does not give local treatment so much as 
he gives attention to the nerve supply of the support- 
ing organs. In very bad cases it is customary to re- 
place the organ by local work once or twice per week. 

MISPLACEMENTS OF THE UTERUS. 

Misplacements of the Uterus. We find it out of 
position latterly, forward, backward, downward and 
upward. The least frequent of these is the upward 
one and may be natural, as in the case of pregnancy, 
when it is forced out of the pelvis on account of its 
size after the fourth month. It is also forced upward 
by tumors and other growths. The backward displace- 
ments are two : retroversion and retroflexion. In 
version the uterus is simply tipped ; in flexion it is bent 
on itself. There are various degrees of retroversion 
and retroflexion. The forward misplacements are 
two: anteversion and anteflexion. The downward 
displacement is called prolapsus; when complete, pro- 
cidentia. We often find a complication of these dis- 
placements. 

Prolapsus of the Uterus. When we find the 
uterus lower than normal we call it prolapsus. There 
are three degrees recognized. The mildest form is 
called the first degree. When the cervix is close to 
the vaginal outlet it is the second degree, and when 
the uterus is outside the vagina it is the third degree, 



Misplacements of the Uterus 47 

or procidentia. It is called by the laity '' falling of the 
womb''; also, **female weakness." It is accompanied 
by a backward displacement and comes on gradually 
and very rarely is acute. It is accompanied by back- 
ache and a bearing-down feeling, with an uncomfort- 
able feeling in the vagina and pelvis, and becornes 
worse on standing. There is frequent micturition. 
There is pain in the limbs, frequently extending to the 
calf of the leg, which is cramped; and there is an al- 
most constant ache in the spine between the scapulae, 
which is a referred pain from the mammary glands, 
which are reflexly affected from the uterus. Because 
the uterus is very much congested on account of the 
poor circulation there is menorrhagia. For the same 
reason there are both uterine and vaginal leucorrhea. 
There are headache, stomach trouble, neuralgia and 
pain in the lower abdomen. Painful menstruation is 
sometimes a symptom and the patient becomes tired 
on doing a little work. There is palpitation of the 
heart and shortness of breath. The bladder and rec- 
tum are affected and they often have rectocele and 
cystocele. 

The treatment ought to be given to prevent this 
trouble. The pelvic floors should be kept in proper 
tone by keeping their nerve supply just right. This 
will be accomplished by removing all bony and other 
lesions as soon as they occur. Every woman, when 
she has given birth to a child, should be examined for 
pelvic lesions and they should be corrected at once. 
Do not walk too much after childbirth. Attend to the 
calls of nature. Avoid constipation. Do not wear 



48 Osteopathic Gynecology 



!1 



tight bands nor carry the baby in the arms nor lift it 
much. The best time to replace the uterus is at night, 
before retiring. At first give the spine a treatment. 
See Nos. 32, 34, 43, 47, 48, 50, 52, 57, 58, 68. All of 
these treatments are not given at once, but are re- 
ferred to here so that a choice may be made. The ab- 
domen is now treated as in Nos. 94 to 100. All of 
these figures refer to paragraphs in part two. 

We are now ready to replace. See the positions of 
hands taken when making a local examination. When 
both you and the patient are in the proper position use 
steady, gentle pressure until the uterus is put in place. 
The patient may take the knee-chest position two or 
three times per day and should do so always on re- 
tiring. Continued treatment will cause the uterus to 
become lighter and the ligaments to grow stronger. 
Be sure that all the lower vertebrae, sacrum, coccyx 
and innominate bones are kept in position. Separate 
and close the knees against resistance and frequently i 
contract the sphincter muscles of the rectum as if you f 
were keeping from defecating. Lie on the back and 
slowly elevate the limbs. These exercises will 
strengthen the muscles that support the uterus. Do 
not use astringent washes or pessaries. Do not allow 
the uterus to be stitched to the abdominal wall, nor 
the round ligament to be shortened. It leads to abor- 
tion and difficult labor and is a failure in many cases. 

Anteversion of the Uterus. Inflammation makes 
the organ heavy and causes it to drop forward. Tu- 
mors and pregnancies do the same. The patient will 
complain of frequent micturition and there may be 







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Misplacements of the Uterus 53 

cystitis. The anterior fornix is shallow and the cervix 
is high. The fundus is felt through the anterior for- 
nix. A rectal and bimanual examination makes the 
diagnosis certain. To replace the uterus treat the 
spine and abdomen as in prolapsus, and place in the 
dorsal position with a pillow under the hips ; or if you 
are treating on a table you might elevate its cover at 
the foot. Place the finger in the anterior fornix and 
lift the uterus up. Pull downard on the cervix. When 
the patient is thin you can grasp the uterus through 
the abdomen with the external hand, and as you thus 
hold it between both hands it can be put in place. You 
can not do this with a fat person. With the girl or 
unmarried woman avoid local treatment if possible. 
Elevate the hips and manipulate the abdomen upward 
from the pubic bones. The prognosis is good if the 
general health is good. 

Anteflexion of the Uterus. The organ is bent for- 
ward on itself. This tends to close the canal of the 
uterus. The usual place of the flexion is at the junc- 
tion of the cervix and the body of the uterus, and here 
the muscle fibers are weakened. When this condition 
exists for some time tissue changes take place, and the 
concave side becomes hard and the flexion is very hard 
to cure. Adhesions form on account of inflammation 
and the position is fixed. A lesion that affects and 
weakens the anterior wall of the uterus is one of the 
principal causes. The walls are inflamed and weak. 
Lifting and other strains force the body of the uterus 
farther forward and the flexion continually grows 
worse. Tight clothing makes the condition worse. 



54 Osteopathic Gynecology 

The symptoms are frequent micturition, cystitis, back- 
ache. If there is inflammation of the Hning of the 
uterus, called endometritis, there will be dysmenorrhea, 
or painful menstruation. If there is no endometritis 
the pain will stop when the flow starts. On examina- 
tion the cervix is in normal position, but the posterior 
lip is shortened, and as we examine the anterior wall 
of the uterus in the anterior fornix we find a curve 
where the uterus is bent on itself. 

The treatment is first directed to the correction of 
all bony lesions. In replacing the uterus have the hips 
elevated. With one finger in the vagina raise the or- 
gan, when it may be taken by the other hand and 
placed in position. When the patient is too fat we 
must rely on the vaginal finger to do the work. If 
there are adhesions they must be broken up gradually 
by massage. To do this hold the uterus up with one 
hand and massage through the abdomen with the oth- 
er, as the patient can stand the treatment. See the 
treatment for anteversion and treat girls like there de- 
scribed whenever possible. 

Retroflexion of the Uterus. Retroversion pre- 
cedes this trouble in most cases. Inflammation is a 
forerunner. Lumbar vertebrae, innominate and sacral 
lesions act as a cause. Constipation is often found be- 
fore. This is a very frequent condition confronting 
the gynecologist. Sometimes it is a cause for sterility, 
but very frequently comes on after the birth of a child. 
When the patient is lying on her back a great deal, 
after childbirth, the uterus is forced back and down 
by the pressure of the intestines. Adhesions are 



Misplacements of the Uterus 55 

formed, resulting from inflammation, and soon a case 
of well-developed retroflexion is in existence. 

The symptoms are backache, headache, pain in the 
back of the neck, with a drawing sensation, pain in 
the limbs, sometimes sciatica. There is pain between 
the scapulae, and when there is metritis, inflammation 
of the uterus, there is considerable pain in the pelvis. 
When there is endometritis there is leucorrhea. 
There is dysmenorrhea in some cases. In making a 
diagnosis the simplest way is to insert the finger in 
the rectum while the patient is lying on the side. It 
comes in contact with the fundus through the rectal 
wall. If there are no adhesions it may be pushed for- 
ward into place. The uterus is mostly muscular fiber, 
and it takes some time to make a permanent correc- 
tion, during which all bony lesions of the surrounding 
tissues should be corrected. The author once treated 
a case of retroflexion which he discovered while he 
was treating a case of piles. The patient had said 
nothing about the retroflexion, thinking it incurable, 
because it had been once fastened to the anterior ab- 
dominal wall by a surgeon, but had broken loose be- 
fore leaving the hospital. In that case the uterus was 
pushed forward through the rectum and was grasped 
by the other hand through the abdominal wall and 
pulled and straightened into place. The patient was 
very thin. This case was cured in less than three 
months. It had been the cause of piles and stomach 
trouble. The case was treated three times per week 
and the uterus worked with once per week. Adhe- 
sions may be corrected by absorption. This is done 



56 Osteopathic Gynecology 

by correcting the circulation through adjusting the 
surrounding tissues. In treating a case, give the ab- 
dominal and spinal treatment as in prolapsus, which 
see. The patient should take the knee chest position 
as in the treatment for prolapsus. Do not wear tight 
clothing and avoid lifting. Complete cures are the re- 
sult. 

Retroversion of the Uterus. In this trouble the 
uterus is tipped back but not bent. It varies from a 
slight misplacement to being tipped as far back as it 
should be to the front. The causes may be enumer- 
ated as sudden movements, slips, falls, lifting while in 
a stooping position and strains while carrying a load. 
It tends to retroflexion, and lesions of the innominate 
bones, sacrum and lumbar vertebrae predispose to the 
trouble. The symptoms are those of retroflexion and 
the treatment is much the same.. 

Lateral Deviations. There are no new symptoms. 
The innominate is generally at fault on the same side. 
This should be corrected and the uterus replaced. In 
cases of uterine displacements we may expect to have 
disturbances of the ears, eyes, teeth, thyroid glands 
and tonsils. The mammary glands, heart, liver, stom- 
ach and kidneys are affected. There may be pain in 
the legs, feet, heels and toes. 



Tumors of the Uterus 57 



TUMORS OF THE UTERUS. 

Tumors of the Uterus. About one-fifth of all 
women over thirty-five years of age are subject to this 
disorder. Women who do not have children have 
them most frequently. There are three varieties with 
reference to position. They are submucous, interstital 
and subperitoneal; inside of the uterus, in the wall of 
the uterus and outside of the uterine wall. Lesions 
of sacrum, innominate, and a stiff, smooth lumbar 
spine predispose to them. Anything that causes re- 
peated pelvic congestion will cause a tumor. Among 
these may be mentioned coitus, masturbation and un- 
gratified sexual desire. The uterus was intended to 
bear a child, and when this is impossible it often pro- 
duces a tumor. A misplaced uterus tends to their 
formation. The symptoms are hemorrhage, backache, 
pain as in childbirth, when the tumor is inside of the 
uterus and pedunculated ; abortion, sterility and, in 
general, the symptoms of a misplaced uterus. When 
there are large tumors they may be palpated as irreg- 
ular masses through the abdominal walls. When you 
use the bimanual method of examination you may de- 
termine the hardness and size of the tumor. Pregnan- 
cies, cancers, displaced uteri and impacted bowels are 
mistaken for tumors and sometimes vice versa. Hard, 
large, fibrous tumors are slow in yielding to treat- 
ment. The symptoms of one as large as a croquet ball 
will be removed in a year, but not the tumor. Solid 
uterine fibroids occasionally disappear at the meno- 



58 Osteopathic Gynecology 

pause without treatment. In treating, remove all bony 
lesions and lift it up as much as you can. See No. 97. 
This improves the circulation. Do not massage the 
tumor. Keep the patient from walking or standing 
too much and avoid constipation. In case the patient 
has a large, hard tumor and it causes considerable pain 
and the patient is not near the change of life, you 
might advise an operation, but when the tumor is 
small, or there is no pain, or the menopause is near- , 
ing, never have the patient submit to an operation. A | 
patient had severe pains at the menstrual time for 
years. A hypodermic was always administered and 
the doctor advised an operation. This continued for 
eight years and the woman was denied children. On 
examination a tumor inside the uterus was found. 
The lower lumbar vertebrae were stiff and straight. 
After six weeks a tumor the size of a hen's egg was 
passed at the menstrual period, and a month later a 
number of smaller ones were passed. After that the 
patient bore a fine boy. The severe pains spoken of 
were caused by the uterus attempting to expel the 
tumor at the menstrual period. They were like child- 
birth pains. 

CANCER. 

Cancer or carcinoma is a malignant disease. It 
frequently attacks the cervix, mammary glands and 
face. Heredity and age are causes. The almost con- 
stant irritation of a part tends to set up a cancer. 
Operations act as a cause. Many cases diagnosed as 
cancer have been cured by the Osteopath. When it is 



Cancer 59 

a uterine cancer hemorrhage will result. Sometimes 
the flow is almost constant. When ulceration sets in 
there will be a watery discharge and the odor will 
grow very offensive as the ulceration grows worse. 
Then there will be sharp, shooting pains in the pelvis, 
back and limbs, and the disease will afifect other or- 
gans by continuity of tissue. The patient has a pecul- 
ior-looking face after the ulceration begins. It is 
called a cancerous face and becomes a light yellow. 
There is loss of flesh, stomach trouble and general de- 
bility. In making a local examination the cervix is 
soft and easily broken. This is a disease in which in- 
spection may be allowed and the cervix has a rough, 
cauliflower appearance. It hardly ever appears before 
the age of forty-five. Do not make the mistake of 
diagnosing an ordinary tumor, laceration, ulceration or 
erosion as a cancer. In treating cancer work to im- 
prove the circulation. Do most of the work in the 
lumbar and sacral regions. See Nos. 32, 43, 47, 48, 
50, 52, 57, 58, 68. 



60 Osteopathic Gynecology 



INFLAMMATION OF THE UTERUS. 

Endometritis is an inflammation of the lining of 
the uterus. It may be caused by exposure to inclem- 
ent weather, any mental shock, which would stop the 
menstrual flow, overwork, the use of pessaries in the 
vagina, or the introduction of foreign bodies into the 
uterus; drugs, gonorrhea, induced abortions, parturi- 
tion. Back of all is the lesion. The most common le- 
sions are of the innominate, sacrum and lower lumbar 
vertebrae. These lesions weaken the uterus by dis- 
turbing the nerve supply and reducing its resistance 
to disease, and also make it more liable to misplace- I 
ments, which in turn are a cause of endometritis. 

The symptoms are the symptoms of all inflamma- 
tions : heat, pain, redness and swelling. They extend to 
surrounding tissues and cause abdominal pains. Pain- 
ful menstruation is in proportion to the inflammation 
and there are whitish, milky-looking discharges. Head- 
ache, backache and various reflex pains are found in 
common with other uterine disturbances. The treat- 
ment is to remove all bony lesions. Their removal 
stimulate the nerves to a better work and improves the 
circulation. Remove all causes for the trouble. Do 
not allow curettage. Do not use any great amount of 
hot water douches. 

Metritis is a most important subject from the 
gynecologist's point of view. It is an inflammation of 
the body of the uterus. It is found in connection with 



Subinvolution 61 

endometritis, and each may be caused by the other. It 
may extend to the surrounding tissues, and perimetri- 
tis is the result. The causes are in part the same as 
in endometritis (which see). The bony lesions are 
very important. The symptoms are more severe than 
in endometritis. The abdomen is tender and some- 
times swollen. There are symptoms of peritonitis. 
There is pain in the uterus, pelvis and back. There is 
much bad-smelling leucorrhea. Some persons will 
have all the symptoms of hysteria. There is often pro- 
nounced stomach trouble. The whole body of the 
uterus is large and soft. 

The treatment is directed to the removal of all bony 
lesions, full directions for which will be found in the 
second part of this book. The bowels should be kept 
open. Being in the open air is a splendid thing, but 
keep off the feet. 



SUBINVOLUTION. 

Subinvolution is a condition where the uterus 
does not contract as it should after childbirth or abor- 
tion. The causes are bony lesions, producing a weak- 
ness of the organ. These lesions may occur at the 
time of childbirth. Among other causes which con- 
tribute to the condition is the fact of not nursing the 
child. The nerves of the nipple when stimulated by a 
nursing child act reflexly and help contract the uterus. 
When the uterus remains large and relaxed the sur- 
rounding tissues are the same. Even the abdomen is 



62 Osteopathic Gynecology 

enlarged. Do not get up and around too soon after a 
child has been born. You may have all the symptoms 
of a misplaced uterus and they will vary with the in- 
flammation set up. In fact, the trouble leads to various 
forms of misplacements, through weakness of the sup- 
ports. 

The treatment consists of removing all bony lesions 
that are found. Give a strong and vigorous treatment 
in the lumbar and sacral regions for the purpose of 
stimulating the nerves and contracting the muscles of 
the uterus and its supports. See Nos. 43, 47, 50, 57, 
and 58. Lift up the load of pelvic contents out of its 
enteroptosed condition. See Nos. 94 to 100. Have the 
patient assume the knee chest position often. It is 
well to do this just before retiring as well as at dif- 
ferent times during the day. 



SALPINGITIS. 

Salpingitis is an inflammation of the Fallopian 
tubes. It is not very often found alone, but there is in- 
flammation of the uterus or ovaries accompanying the 
condition. It is very often found only on one side. 
There are all the symptoms of inflammation present, 
and if it is caused by gonorrhea it is almost incurable. 
If there is any flow the menstruation is very painful. 
The least motion of the body produced in walking or 
riding causes pain in the tubes. A chronic case of the 
disease may follow an acute attack. A latent form of 
gonorrhea, in the husband, may cause a chronic form 



Salpingitis 68 

of salpingitis in the wife, and it most likely can never 
be cured. The Osteopathic treatment is for the pur- 
pose of removing all bony lesions existing in the pelvis. 
Some careful work may be given in the abdomen, as 
in paragraphs No. 94 to 100. 



64 Osteopathic Gynecology 



DISEASES OF THE OVARIES. 

The diseases to which they are subject are misplace- 
ment, inflammation and tumors. As they are in the 
walls of the broad ligament they are placed out of 
position every time the uterus is misplaced. In cases 
of retroflexion they may be found in the pouch of 
Douglas, and in cases of constipation are quite painful 
as the fecal mass passes, as it presses upon them. 
Such an ovary causes nausea when pressed upon. 
When the patient is thin one may palpate them 
through the rectum or on bimanual examination and 
they will cause a pain similar to pressure on a testicle. 
You will find pain in the knee, heel, and also in the 
back, in the region of the three lower dorsal vertebrae. 
Nausea and vomiting are common. The ovary is very 
much subject to congestion at the menstrual period. 
Ungratified sexual desire is a common cause. This 
increases the blood flow to the ovaries. The trouble 
may follow scarlet fever, smallpox and mumps. When 
treating this condition relax the muscles of the back. 
Work carefully over the congestion and inflammation 
to relieve it. See paragraphs 94 to 100. Rest will 
be advised. The ovary may be placed in position by 
very gentle pressure when the patient is in the knee- 
chest position. The index finger will be placed in the 
posterior fornix of the vagina for that purpose. 
Splendid results may be gotten from the treatment 
when it is carefully given. 



Sick Headache 65 

Ovarian Tumors. These are mostly cystic. Treat 
as above and for ordinary fibroid tumors. In most 
cases you will perform a cure. Be sure and treat all 
the vertebral lesions and look for them in the lower 
dorsal. 



SICK HEADACHE. 

(Migraine, Hemicrania, Cephalgia.) 

Migraine is an intense headache, occurring fre- 
quently, with or without disturbances of vision or 
of nausea. Medical writers as a general rule claim 
that no lesions have been discovered, but Osteopaths 
frequently find neck lesions, and also upper dorsal 



! 



66 Osteopathic Gynecology 

lesions, the removal of which has resulted in cures. 

The patient can tell for some time previous when 
an attack is to be expected, by the sensations and 
symptoms peculiar to each given case. The pain 
at the beginning of an attack is on both sides of 
the head, but after awhile it localizes on one side. 
With some patients the attack localizes on one side 
at one time ; at the next time it localizes on the other 
side. Some cases continue from childhood to old 
age. 

Most of the lesions have been found in the neck 
and upper dorsal region, though some have been 
found in the lower dorsal and lumbar regions. 
Stomach troubles, uterine misplacements, eye strain, 
and tumors are sometimes responsible. These causes 
must have special treatment. 

Treatment. The neck must be thoroughly ma- 
nipulated. See Nos. 1, 3, 5, 7, 9, 10, 11, 13. All 
spinal muscles and tissues should be relaxed. Nos. 
4, 43, 48, 53. The abdomen should receive a deep 
inhibitive treatment. Nos. 94 to 99. Give heavy 
pressure over the solar plexus. No. 100. Misplaced 
vertebrae and ribs should be corrected. Tissues over 
the nerves in the face should be relaxed. Nos. 14, 
20, 21. Work vigorously and deeply with thumb and 
finger on a line straight over the head, from the 
nose to the base of the skull at the back of the neck. 
See No. 16. Give heavy pressure on the skull. No. 
15. Give heavy deep treatment at the base of the 
skull, on each side of the spine. This may be tem- 
porarily painful, but will be effective. No. 7B. 



Sick Headache 67 

Pressure may be given in the upper dorsal region. 
No. 67. The clavicles should be raised. Nos. 72, 73. 
The treatment should be given deliberately, and is 
probably the longest that the Osteopath gives. Great 
relief should be given during the first treatment. 
A very general treatment will be helpful. See gen- 
eral treatment. Give particular attention to the 
stomach and bowels. The patient should avoid over« 
exertion, as becoming tired acts as an exciting 
cause. A hot mustard foot-bath, heat at the base of 
the skull, and an ice bag on the forehead is often 
helpful. Should there be nausea, use the ice bag on. 
the spine from the fourth dorsal down to the first 
lumbar vertebra. Some patients are helped by a 
cup of strong, clear coffee. 

The drug treatment for this condition is very 
unsatisfactory. Headache powders, pills and the 
various pain killers are dangerous. The extract of 
cannabis indica is sometimes given for a long time, 
two or three times per day, in doses of a fourth to a 
third of a grain in hope of curing the condition. At 
the time of the attack the following pills are some- 
times given : 

Acetanilid 20 grains. 

Codein Sulphate 5 grains. 

Camphor monobromate 5 grains. 

Make of this ten pills and take one every two hours 
until relieved. The heart action should be watched 
when using these pills. Menthol pencils are used 
locally for the purpose of relieving the pain. Rub 
them over the seat of the pain. 



68 Osteopathic Gynecology 

TUMORS. 

Fibroid Tumors, Benign Tumors, Malignant 
Tumors.) 

Tumors of every nature have been removed by 
osteopathic treatment. In addition to those above, 
many uterine tumors, as well as ovarian and cystic 
tumors, fatty tumors, abdominal and intestinal tu- 
n ors, even those supposed to be of cancerous nature, 
have been removed under the treatment. Especially 
good results have been secured with tumors of the 
breast. 

The cause for most tumors will be foun3' In some 
spinal or other bony lesion, or in some misplaced 
soft tissue which interferes with the nerve supply 
or with the circulation, especially of the venous 
and lymphatic drainage of the part afifected. When 
the blood or lymph at any given point is obstructed, 
whether it be from a defective nerve supply or by 
direct pressure of some bone or organ, that blood or 
lymph often causes an abnormal growth or tumor. 

Abdominal Tumors. In case the tumor is located 
in the abdomen it will be well to carefully examine 
the spine for any spinal lesions, and remove them, 
using Nos. 34, 43, 44, 36, 37, 41. The ribs must be 
carefully looked after and any misplaced ones must 
be corrected. See Nos. 81 to 93. The abdomen 
must be carefully treated, as in Nos. 94 to 100. 
Should there be enteroptosis (which see), that must 
be treated according to directions. In general, tumors 
should not be worked directly-over or massaged, 



Tumors 69 

but they may be lifted up and their position carefully 
shifted and adjoining tissues may be manipulated. 
A general treatment is often advisable for the entire 
circulation and for the nervous system. Treat about 
three times per week. When better treat twice and 
once per week. The treatment in the main is di- 
rected to restore the proper circulation. In some 
cases the treatment must be continued for some, 
time, but often the improvement is noted soon. 

Uterine Tumors. Intrauterine, extrauterine or in- 
terstitial tumors are frequently removed by osteo- 
pathic treatment. The intrauterine tumor is fre- 
quently pedunculated, and at the menstrual period 
causes great pain, because the uterus at that time 
tries to expel it. The interstitial is a part of the 
enlarged wall and the extrauterine is on the outside 
of the wall and attached to it. These tumors are 
frequently caused by a misplaced uterus. This cor- 
rection should be made by a well-qualified practi- 
tioner. Very frequently there is a luxated pelvis, or 
innominate bone, or a misplaced vertebra which, 
when corrected, restores the proper circulation and 
results in the removal of the tumor. In addition to 
the local corrective work necessary the spine and in- 
nominates may be treated. See Nos. 43, 51, 52, 57, 
104 to 112. In addition to the above a general treat- 
ment, which see, will be found very beneficial as the 
patient is generally nervous. 

Ovarian Tumors will require a careful examina- 
tion of the lower spine and the removal of all lesions 
found, and the pelvis should be looked after and 



70 Osteopathic Gynecology 

treated in the same careful manner. See; treatment 
for uterine tumors. The abdomen should be careful- 
ly treated as in Nos. 94 to 100. Lift up the tumor and 
carefully manipulate the tissues about it, but do not 
work directly over it. 



HYSTERIA. 

Hysteria is a functional disease of the nervous 
system. It is characterized by loss of self-control, and 
accompanied by disorders of all or a part of the bodily 
functions. It occurs most frequently in women and 
children. 

Osteopaths look for the primary cause in some 
bony lesions of the spine, or ribs, or pelvic bones, 
or some malposition of some organ. The second- 
ary causes may be emotional disturbances, mental or 



Hysteria 71 

physical strains, domestic troubles, masturbation, 
sexual excesses, ovarian or uterine diseases. 

The symptoms cannot be said to follow any fixed 
rule, as a hysterical patient can imitate any symptom 
or diseased condition. The patient frequently feels 
a ball in the throat, which seems to come from be- 
low and produces a choking sensation. This is re- 
ferred to in medical literature as '' globus hysteri- 
cus." There may be convulsions, after which the 
patient seems to be bloated with gas, and passes 
large quantities of urine. The voice is often lost 
and the various forms of paralysis are often simu- 
lated. The joints may become stiff and there may be 
spasms. Intense pain may develop in the head, 
spine, abdomen, or ovarian region and in the breast. 
There may be rapid and difficult breathing, vomit- 
ing and nausea. The temperature is nearly always 
normal. 

Treatment. Particular attention should be given 
to the lower ribs. They are often found displaced, 
generally downward. See Nos. 90, 91, 92, 93. The 
intestines should be lifted up. See Nos. 96, 97. A 
general relaxing treatment should be given. See gen- 
eral treatment. Remove any lesions found in the 
spine or ribs. A change of environment may be 
helpful in many cases. The patient should be dealt 
with kindly, yet firmly. If possible, get the patient 
to exercise self control. A warm tub bath twice per 
week and a cold sponge bath every morning, fol- 
lowed by a brisk rub, will prove helpful. Out of 
door exercise should be taken each day. If a child, 



72 



Osteopathic Gynecology 



avoid overstudy under competitive methods. Avoid 
overindulgence of every nature. Let the diet be plain 
but let there be plenty of nutriment. 



fli 



Insomnia 73 

INSOMNIA. 
(Sleeplessness.) 

Insomnia may b@ due to various causes. Con- 
gestion or anaemia of the brain, Bright's disease, 
liver, stomach and intes-tinal disorders may cause 
sleeplessness, or it may be due to nervousness or 
excessive headache. The Osteopath believes, and 
has splendid success in following it out to its legiti- 
mate conclusions, that the basis of the trouble ma} 
be found in some bony, ligamentous or other lesion, 
that disturbs the circulation and allows pressure to 
disturb proper nerve function. A large number 
of these cases are met and successfully overcome 
by the Osteopath. Frequently an improvement is 
noted with the first treatment. In many cases but few 
treatments are required. 

In treating for this disorder the Osteopath looks 
for neck and upper spinal lesions. He pays partic- 
ular attention to the clavical and two upper ribs. 
See Nos. 72, 73, 75 to 81. 

Fully relax all spinal tissues. See Nos. 34, 36, 43, 
44, 53. Give a strong abdominal treatment. See 
Nos. 94 to 100. After the specific lesions, that are 
found, are treated, a general treatment is in order. 
See general treatment. 

When the person is excitable and there is a feel- 
ing of distension in the head, it will be well to keep 
the bowels regular. See the treatment for consti- 
pation. At night before retiring a hot bath, fol- 
lowed by a cool sponge bath, will be beneficial. 



74 Osteopathic Gynecology 

Another help is a cold pack applied to the abdomen. 
This soon becomes warm and draws the blood there. 
See cold pack. Ten minutes of good, cool, pure air, 
breathed properly, will materially assist in gaining 
needed rest. See correct breathing. It is often rec- 
ommended that a glass of warm milk be taken just be- 
fore retiring. Medical writers recommend a dose of 
trional, ten to twenty grains, to be given with food 
half an hour before retiring. 

If the insomnia is caused by anaemia of the brain 
the patient is apt to start sleeping very well, but 
wakes later and can not fall asleep again. In ad- 
dition to the osteopathic treatment as outlined 
above, cold water or ice, then hot water, may be 
applied to the spine in long rubber bags, each for 
fifteen minutes. For this form of insomnia medical 
treatment would recommend some form of stimu- 
lant at bed-time, say one-sixtieth of a grain of 
strychnine, or some form of alcoholic drink. 

NEURALGIA. 

(Facial Neuralgia, Brachial Neuralgia, Intercostal 

Neuralgia, Spinal Neuralgia, Neuralgia of 

the Stomach, Tic Douloureux.) 

Neuralgia is a severe pain along the course of a 
nerve, unaccompanied by any change in the body 
of the nerve. 

The Osteopath usually finds some bony or mus- 
cular lesion causing pressure on the nerve or on 
some of its connections. A misplaced vertebra is 



Neuralgia 75 

a very common cause. In cases of facial neuralgia 
we expect to find contracted muscles in the neck 
or a misplaced atlas or axis, the first and second 
cervical vertebrae. Treatment for this v^ould be as 
in Nos. 1, 3, 5. In brachial neuralgia, which in- 
volves the arm and shoulder, we look for lesions 
from the first cervical to the sixth dorsal. This will 
be treated as in Nos. 1, 3, 5, 9, 10, 11, 34, 43. All 
the upper spinal and neck tissues will be relaxed 
as in Nos. 5, 83, 34. Intercostal neuralgia is easily 
handled and is frequently caused by a twisted or 
misplaced rib or ribs too close together. Treat as 
in Nos. 75 to 89. Thoroughly relax all spinal tis- 
sues, as in Nos. 35, 36, 47, 48, 50. 

Spinal neuralgia and neuralgia of the stomach 
will be caused by misplaced vertebrae, the stomach 
lesions occurring from the fourth to the eighth 
dorsal. See spinal treatments. Nos. 43, 34. 

Tic douloureux is a neuralgia of one or more 
branches of the fifth nerve, and lesions are looked 
for in the upper dorsal and cervical regions. A 
misplaced atlas or axis is most frequently to blame 
for the condition. Treat as in Nos. 1, 3. Pay atten- 
tion to the upper back tissues, as in Nos. 34, 43. In 
many cases a thorough abdominal treatment will be 
of assistance. See Nos. 94 to 100. In all cases of 
neuralgia or of neuritis the muscles and nerves 
should be relaxed. 

In facial neuralgia, tic douloureux and brachial 
neuralgia a hot water bag may be applied to the 
back of the neck and the upper dorsal region. Tic 



76 Osteopathic Gynecology 

douloureux has been helped locally by the application 
of the inner skin of a fresh egg, sprinkled with black 
pepper. Some medical writers in cases of tic doulou- 
reux, recommend one one-hundredth of a grain nitro- 
glycerine until relief is obtained. 



I 



Obesity 77 

OBESITY. 
(Corpulence.) 

Obesity is an excessive amount of fat, that not 
only becomes an inconvenience but seriously im- 
pairs the health by infiltrating and weakening the 
heart muscles, also the lungs, liver and kidneys. 

The controlling factors may be heredity, bac 
habits of eating and drinking, lack of exercise, and 
spinal lesions which interfere with the proper work 
of the liver, pancreas and lymphatic system. 

This condition must not be overcome too sudden- 
ly. The lesions may be removed as soon as possible. 
The clavicles are to be raised and the first rib 
lowered. See Nos. 72, 73, 75, 76. A thorough spinal 
treatment must be given for the stimulation of the 
liver, pancreas and kidneys. See Nos. 32, 43, 57. 
Vigorous treatment over the fat tends to its absorp- 
tion. Give a general treatment, which see. 

Diet. The diet must be restricted. Starches, fats 
and sweets are to be eliminated as much as possible. 
The use of water is to be restricted and alcoholic 
drinks are to be prohibited. 

Regular exercise must be taken. If the heart is 
weak begin moderately and gradually increase the 
exercise. Walking is very beneficial. 

Some medical authorities give from three to five 
grains of the dry, powdered thyroid gland, three 
times per day. It must be discontinued when it 
causes any heart disturbance. It should not be tak- 
en if there is any heart trouble. 



'?8 Osteopathic Gynecology 

CYSTITIS. 

(Inflammation of the Bladder.) 

This inflammation may be acute or chronic, and 
may be caused by gonorrhoea, unclean catheters, re- 
tention of urine, and colds. 

The symptoms are bearing down pains over the 
bladder, with tenderness in the same region on pres 
sure. The urine is scanty and often highly colored^ 
It may be tinged with blood and contains blood and 
mucus. 

Treatment. The patient should rest in bed, with 
the hips slightly elevated. Remove any lesions found 
in the lower dorsal an.d lumbar regions, and stim- 
ulate over the lumbar and sacral region. See Nos. 
51, 52, 57, 58. Should there be pain in the bladder 
inhibit in the above regions. See No. 67. Local 
abdominal treatment should be given, lifting up on 
the contents of the abdomen, especially the lower 
part. See Nos. 96, 97. Give a thorough general and 
inhibitive treatment to the bowels. This helps to 
draw the blood away from the bladder. See Nos. 
94, 95, 100. Treat in acute cases once or twice daily. 

Hot sitz baths and hot applications over the blad- 
der will be helpful. Use the liquid diet. Drink 
plenty of water. Peppermint tea is splendid. The 
medical treatment often recommended is to keep 
the bowels open with the use of salts. Irrigation 
of the bladder, with a soft rubber tube and a foun- 
tain syringe, using a two per cent solution of boric 
acid. A formalin solution is used for the same pur- 



Uremia 79 

pose, five to ter drops to a pint of water. In either 
case the water should be sterilized by boiling. 

UREMIA. 

Is a poisoned condition of the sybtem, which some- 
times develops in nephritis or anuria, due to the 
presence of toxic material, which should have been 
eliminated by the kidneys. It may also follow gout, 
scarlet fever and typhoid fever. 

The onset is sudden, the face is pale, pulse is slow. 
There is often a dropsical condition and the breath- 
ing is difficult. The urine is scanty and contains al- 
bumen. There is nausea, vomiting, delirium and 
convulsions. There may be paralysis. 

The treatment is administered for the purpose of 
stimulating the kidneys and skin to activity. Thor- 
ough work must be performed from the fifth dorsal 
to the second lumbar vertebra. See Nos. 43, 44, 
48, 51, 52. Treat the abdomen deeply and thorough- 
ly at and above the umbilicus. See Nos. 94 to 100. 
Treat the upper dorsal and neck region to stimulate 
the heart and lungs. See Nos. 53, 1, 5, 7B, 7C. 
Raise the ribs. See Nos. 81, 88. Treat strongly at 
the base of the skull. See No. 7B. Give a warm 
salt water enema, in which a tablespoonful of salt 
has been dissolved to each quart of water. Hot 
packs will help to induce sweating. 

Some medical authorities advocate active pur- 
ging, with the use of salts. To induce sweating use 
either the hot bath or give one-tenth of a grain of 
pilocarpine three times per day. 



. \ 



80 Osteopathic Gynecology 

ANURIA. 
(Suppression of Urine.) 

Anuria commonly means that the urine does not 
reach the bladder, a suppression of urine. Cases 
in which the suppression is absolute are very rare. 

The trouble may be caused by acute Bright's dis- 
ease, by lowered pressure of the blood, or when the 
fluids are depleted by diarrhoea. The ureter of a 
healthy kidney may be obstructed by pressure, or 
calculi may block both ureters. Severe injuries, or 
an operation, or lead, turpentine or phosphorus 
poisoning may act as a cause. Patients have lived 
for ten days with complete suppression of the urine. 
One writer records recovery after a suppression of 
nineteen days. 

Treatment should be given mainly to stimulate 
the spine at the tenth, eleventh and twelfth dorsal 
vertebrae. This may be extended from the sixth dor- 
sal to the second lumbar vertebra. See Nos. 43, 44, 
48, 51, 52. 

Draw the muscles away from the spine, as in Nos. 
31. Treat the abdomen in a thorough manner to 
draw the blood there and relieve congestion. See 
Nos. 94 to 100. The bowels should be kept open. 
The skin should be kept active by hot tub baths 
and hot packs. Hot salt water enemas should be 
taken. 



St. Vitus' Dance 81 

ST. VITUS' DANCE. 
(Chorea.) 

Chorea is a disease characterized by an incoordi- 
nate movement and twitching of the muscles either 
local or general. There is often some slight psychic- 
al disturbance and great liability to endocardi- 
tis. About three-fourths of the cases are girls be- 
tween the ages of five and seventeen. In many 
cases the disease is hereditary. Among the excit- 
ing causes may be mentioned fright, worry, grief, 
modern forced methods of education, eye diseases 
or weakness. 

The Osteopath expects to find some anatomical 
lesions as a predisposing cause, the correction of 
which leads to the cure of the disease. 

The symptoms manifested in chorea have such a 
wide range and are so varied in character that for 
convenience they are classified under thre^ divi- 
sions in which the mild, severe and most severe or 
extrerne cases are described. The disease gene-rally 
attacks a hand with a jerky motion, then attacks 
the face, and later the legs. In the mild forms only 
the hand or hands and face are attacked. The child 
is restless, cries easily and often. Ther.e is head- 
ache and pains in the limbs. The patient loses the 
temper frequently and is easily frightened at night. 

In the severe forms the trouble becomes more 
general in character. The speech is affected and 
the patient may be unable to dress and attend to 



82 Osteopathic Gynecology 

ordinary duties. The extreme form may develop 
into insanity. 

Treatment. The disease yields most readily to 
osteopathic treatment. The lesions are usually in 
the upper dorsal and cervical regions. Muscular 
tissues are found in a tightened condition. Of 
course the first thing for the Osteopath to do as 
soon as possible is to remove the lesion. In addi- 
tion, a thorough general treatment is indicated. 
See general treatment. Special attention should 
be given to the groups of muscles most affected. 
They should be thoroughly massaged, and the limb 
or arm, as the case may be, thoroughly manipulated. 
See Nos. 113, 114, 131. Treatment should be given 
daily until the patient is better, then three times per 
week and later twice per week. The cases ordi- 
narily call for a long course of treatment. 

Make sure that there are no intestinal worms, 
eye strain, sexual disorders, cause for worry, mental 
strain, overwork or severe muscular exertion. At- 
tention should be given to the heart and bowels. 
See constipation. A soap suds enema may be used 
when necessary. 

The Diet. Sweets and starches are better left 
alone, otherwise the patients may be encouraged to 
take as much nourishing food as they can digest. 
Meat, eggs, oysters, fish with plenty of green vege- 
tables are recommended. 

A warm bath on retiring and a cool sponge bath 
with a brisk rub on rising will be found to be bene- 
ficial. 



Deep Breathing 83 

DEEP BREATHING. 

A great deal may be accomplished by the patient 
herself in regaining her health and in keeping it when 
it has been restored. The general health may be great- 
ly benefited, and help thus gained will aid in overcom- 
ing special diseased conditions. It is well for the pa- 
tient to secure all the oxygen possible. This acts as 
a food, the cheapest and best in the world, and it is 
a great blood purifier and tonic. While enjoying this 
medicine the muscles of the chest may be built up and 
its capactity greatly enlarged. Proper breathing will 
help. To do so properly you should be in a very well- 
ventilated room. Even in cold weather throw open 
the windows. Out of doors would be better. Have 
the clothing loose and all the muscles relaxed. Stand 
easily with the hands on the abdomen. Now take a 
full, deep breath slowly, allowing the abdomen to swell 
outward. Then exhale slowly forcing the abdomen in. 
The abdominal type of breathing brings into full play 
the diaphraghm, which increases the capacity of the 
chest and aids in expelling the air. It also strengthens 
the abdominal and pelvic organs. When you can 
breathe correctly in this manner (and it will take prac- 
tice) you may inhale a long, deep breath, bringing 
the arms slowly from the sides until they meet over 
the head, at the same time rising on the tiptoes. Ex- 
hale slowly, bringing the arms back to the sides again. 
Do this several times per day, ten or fifteen minutes 
at a time, preferably in the open air. When you 
walk be sure that your breathing is correct. 



84 Osteopathic Gynecology 

STRENGTHENING THE MUSCLES OF 
THE PELVIC FLOOR 

A woman may help in building up the tone of the 
muscles of the pelvic floor, which helps keep the 
uterus in its proper position, by standing, and while 
in that position, using a motion of the muscles about 
the rectum as if she were restraining the act of def- 
ecation. This should be performed for ten or fifteen 
minutes at intervals. 

CONSTIPATION. 

This is a very common trouble with all ages and 
both sexes, but is very prevalent among women, and 
as it aggravates many diseases peculiar to women we 
will consider its treatment here. It poisons the system 
and by undue pressure of the fecal mass against the 
soft tissues, interferes with the circulation in the pel- 
vic organs and is a prolific cause of many diseases. 
Retention and hardness of feces, irregularity and in- 
sufficiency of bowel evacuation, are regarded as con- 
stipation. 

This trouble may be caused by any one or any com- 
bination of the following: Lesions of the spine or 
ribs, affecting the blood or nerve supply of the bowels ; 
poor peristaltic action, mechanical obstruction, impair- 
ment of quality or absence of bile, a flabby or pendu- 
lous condition of the abdominal walls and muscles, in- 
attention to the calls of nature, dependence upon 
purgatives, improper diet, lack of exercise. 

Treatment. The most important thing to do is to 
remove the real cause of the torpidity of the 



Constipation 85 

bowels. The lower half of the spine will be gener- 
ally found at fault. A common condition is a ten- 
sion of the ligaments binding the vertebrae together, 
with a posterior condition of the lower dorsal and 
lumbar vertebrae. This affects the nerve supply to 
the bowels. This may be overcome by a thorough 
loosening up of these tightened conditions by manip- 
ulation, as in Nos. 43, 44, 48, 49, 51, 63. The entire 
muscular structures of the lower part of the back 
must be relaxed. See Nos. 64, 47, 53, 58. The low- 
er ribs if down must be raised. See Nos. 90, 91, 92. 
The bowels should be thoroughly manipulated. See 
Nos. 94 to 100. Fecal obstructions may thus be 
loosened and passed along the intestinal tract. 
Some writers recommend rolling a cannon ball, 
wrapped in some suitable covering, over the intes- 
tines for five or ten minutes each morning and even- 
ing. All spinal lesions, of whatever nature, should 
be removed. See examination of the spine. 

In a very elderly person, or where the abdominal 
walls are flabby and pendulous, a suitable abdominal 
belt should be worn until the tissues can be toned 
up by the osteopathic treatment. This will hold 
the contents from sagging and obstructing the gen- 
eral circulation of the pelvis. 

Every one should have a regular time to go to 
stool, and those liable to suffer from constipation 
should let nothing interfere with this important 
duty. Many cases of fecal retention start from neg- 
lecting the calls of nature. When suffering from 
constipation go whether you feel the necessity or 



86 Osteopathic Gynecology 

not, and when you go do not be in a hurry, but ex- 
pect a movement. Do not strain. It is very injur- 
ious for a v^oman to do so, and in either sex may 
cause piles. 

Stop the use of purgatives, however simple and 
harmless they may be said to be. In using purga- 
tives the doses must be increased, the drug must be 
changed for another, until it is almost impossible to 
secure an action. Nature grows dependent upon 
these and their use only confirms the condition and 
makes the cure all the more difficult. 

Should the bowels prove a little obstinate to the 
above treatment, at first, use an enema, in which 
a tablespoonful of salt is used to a quart of water. 
Use a fountain syringe. Retain the water a half 
hour if you can, meanwhile massaging the bowel 
contents. This should not be done but every other 
day, and must not be continued long. Continued 
use of such a treatment weakens the tissues and 
stops the proper secretions. 

Diet. The diet should receive special attention. 
Most people are accustomed to a too concentrated 
diet, in w^hich there is too little to pass through the 
intestines to help excite the peristaltic action by 
friction on the nerve terminals. All of the following 
foods are splendid for constipation. A diet may be 
selected from them, and in case anything is known 
not to agree with the patient it may be omitted from 
the list: Tomatoes, lettuce, spinach, asparagus, 
beans, peas, corn, potatoes, cabbage, celery, boiled 



Constipation 87 

Spanish onions, carrots, turnips, squash, pumpkin, 
and cauliflower. 

Corn and Indian meal, oatmeal, shredded wheat, 
coarse graham bread, graham gems, bran bread and 
bran biscuits. The bran may be mixed with gra- 
ham or white flour. The bran may also be eaten 
raw, as much as three or four tablespoons per day. 
Olive oil may be eaten on salads, lettuce and toma- 
toes. Use plenty of butter. All fruits with small 
seeds are excellent, such as figs, raspberries, black- 
berries, strawberries, grapes and huckleberries. 

Grapefruit, cherries, prunes, oranges, pears, 
peaches and apples are all splendid. Some of the 
above may be stewed if the raw fruit disagrees. 

English walnuts, butternuts, walnuts and al- 
monds. Water, coffee, cider, grapejuice, buttermilk 
and sour milk are all desirable. 

Foods to Avoid. 

Fried foods, rich sauces and gravies, sweets, 
pastry, pickles, cheese, starchy puddings, tea, sour 
wine, red wine, eggs, milk, or any other highly con- 
centrated foods. 

Two glasses of water should be taken on rising 
in the morning. Drink plenty of water between 
meals and a glass or two on retiring. Water taken 
on an empty stomach is absorbed by that organ and 
goes through the portal circulation to the liver, 
where it performs a healthful work. If plain water 
disagrees, flavor it with lemon juice or a little spice. 



88 Osteopathic Gynecology 

A daily cold bath, followed by a vigorous rub until the 
skin is made to glow, is a useful adjunct. 

If the patient follows a sedentary life, and is in- 
door much of the time, exercise is to be recommended, 
such as walking, horseback riding, tennis playing, 
bowling, etc. 



DROPSY. ^ 

(Ascites, Renal Dropsy.) gjjfl 

Ascites is a dropsical condition of the abdomen, 
due to the accumulation of fluid in the peritoneal sac. 
It is generally caused by some other disease or diseases. 
It may follow diseases of the liver, heart, lungs, kid- 
neys, or it may be secondary to la grippe, fever, etc. It 
may be caused by an obstruction of the portal circula- 
tion or to an abdominal tumor. We look for lesions in 
the spine, in the upper lumbar and lower dorsal re- 
gions, also among the ribs. 



Dropsy 89 

The treatment in general should be directed to 
the removal of the first cause, and in addition we 
should stimulate the kidneys. See treatment in 
Bright's disease. 

It will be well to give a thorough general treatment. 
See general treatment. Special attention should be 
g-iven to the upper dorsal region. Work here will 
stimulate the skin. Give a deep , abdominal treat- 
ment. See Nos. 94, 95. Treat the solar plexus. 
See No. 100. Manipulate and treat the limbs as 
in Nos. 113, 114, 116. Work over the liver and keep 
the bowels active. • See Nos. 93, 101, 102. 

Renal Dropsy. This is an accumulation of fluid 
in cellular tissues and lymph spaces from the arter- 
ies and veins, and is caused by the failure of the 
kidneys to carry off the surplus fluid, as they fail 
to do in various kidney diseases. See acute and 
chronic Bright's disease. The main treatment is, 
of course, directed to the cure of the primary con- 
dition. Keep the kidneys well stimulated by treat- 
ment in the lower dorsal region. Give a thorough 
general treatment for the purpose of toning up all 
the tissues. This assists the general circulation 
and retards the flow of fluid out of the blood vessels 
into the lymph and other spaces. 



90 Osteopathic Gynecology 

ARTERIOSCLEROSIS. 
(Atheroma.) 

This disease is a thickening of the walls of the 
arteries, due to chronic inflammation of the inner coat 
(intima). It is. often hereditary. Gout, syphilis, 
rheumatism, alcoholism, high and fast living act as 
exciting causes. This disease is often a forerunner 
of heart, liver, and Bright's disease and apoplexy. 
One great cause of this disease is overeating. We 
eat too much. We keep it up too long. I agree 
with George Cheyne, that every man after fifty, 
it would be well to begin at forty, ought to lessen 
the amount of his food, and every seven years after 
lessen it sensibly and gradually, and at last descend 
out of life as he ascended into it, even into the 
Child's Diet. He says that this would keep the 
faculties and senses clear and keep us free from 
great and dangerous distempers. He further says: 
" Milk and sweet, sound blood differ in nothing but 
color. Milk is blood." 

Symptoms. They are obscure, but in many cases 
there is a hard, bounding pulse, difficult breathing, 
and insomnia. It generally appears after forty. 

Treatment. A general osteopathic treatment is 
indicated. See general treatment. Stimulate be- 
tween the second and fifth dorsal vertebrae. See 
Nos. 34, 38, 43. Raise the ribs. See Nos. 84, 86. 
Work over the liver. See Nos. 93, 101, 102. Give 
a thorough abdominal treatment. See Nos. 94, 95, 
Stimulate the solar plexus. See No. 100. 



Phlebitis 91 

Diet. Let the meals be taken regularly. Drink 
plenty of water between meals. Leave alcohol 
alone. Use vegetables rather than meat. If there 
are renal symptoms, skimmed milk is a most ex- 
cellent diet. 

PHLEBITIS. 

(Inflammation of Veins.) 

This may be simple or it may be septic, or it may 
be septic with bacteria from some neighboring sup- 
purative process. The veins are firm and painful to 
the touch, and are surrounded by inflamed tissue. 
There is swelling and pain, with some heat. There 
is stiffness of the limb. The skin is discolored. 
Pressure, without or with injury, may act as a 
cause for this disturbance. Often there is no his- 
tory of violence or accident. Most simple cases 
occur in the lower limbs. Should it be in the pelvis, 
ear or portal vein, the condition is most grave and 
surgical assistance may be necessary. 

Treatment. The patient must rest, sometimes for 
a month or six weeks. When the trouble is in the 
lower limbs the trouble is looked for at the eleventh 
dorsal and below this point, as far as the sacrum. 
Remove the lesions as far as possible and give 
stimulating treatment in the lower dorsal and lum- 
bar regions. See Nos. 43, 44, 48, 51, 52. Rotate and 
manipulate the lower limb with great care, as in 
Nos. 113, 114. 

Give slight torsion about ten times eacJi way per 



92 Osteopathic Gynecology 

treatment, as in No. 121. Gently rub tissues of the 
limb in the direction of the heart. 

Diet. The diet should be light. Keep the limb 
elevated as much as possible. Hot fomentations 
may be applied for a while. Some medical authori- 
ties advocate the use of lead water, used as a cold 
compress. 

VARICOSE VEINS. 

Varicose or enlarged veins are more common in 
the lower limbs. In general they are due to an 
obstruction to the return circulation. The condi- 
tion may be partly caused by a diseased liver or 
heart, relaxed abdominal walls, and ptosis of the 
intestines. Constipation may help in increasing 
this disorder, as may a pregnant or misplaced 
uterus. The Osteopath looks for lesions in the 
lower dorsal and lumbar vertebrae, or in a slipped 
innominate bone which brings undue tension on 
some muscles and ligaments. 

Treatment. In general this is a stimulating one 
in the lower dorsal and lumbar regions. See Nos. 
43, 44, 48, 50, 51, 52. Manipulate the limb. See 
Nos. 113, 114, 121. Give abdominal treatment. See 
ISTos. 94 to 100. Lift up abdominal contents. See 
Nos. 96, 97. If the heart or liver is involved, this 
calls for treatment for this special ailment. If 
constipated, see special treatment for that. 

Some medical writers order salts to keep the 
bowels open and order an elastic stocking. Under 
osteopathic treatment the elastic stocking may be 
removed. 



Anaemia 93 

ANEMIA. 
(Secondary Anaemia, Toxic Anaemia.) 
J Anaemia is a term which is used to define any 
[marked change in the blood, in the number of 
either white or red corpuscles, or in the amount of 
the haemaglobin, or albumen. It may be used to 
denote a deficient quantity as well as quality of the 
olood. 

Secondary anaemia refers to anaemia resulting 
from loss of blood, due to hemorrhage. Toxic anae- 
mia is caused by the action of poisons on the blood, 
ras mercury, arsenic, lead and the poisons of syphilis, 
'malaria, etc. For treatment, see Progressive Perni- 
ious Anaemia. 

CHLOROSIS. 



, This is a disease that frequently afifects girls, gen- 
erally between fourteen and eighteen. The patient 
has a yellowish green tinge, from which the disease 
takes its name. The patient retains fat tissue and 
looks plump. At the onset of the disease there is a 
I disposition to be quiet, with no desire for physical or 
mental activity. Palpitation of the heart and diffi- 
:ult breathing are evident on slight exertion. There 
is constipation, headache and vertigo. The menses 
are scanty or irregular or both. The appetite is poor. 
'For treatment see Progressive Pernicious Anaemia. 

PROGRESSIVE PERNICIOUS ANEMIA. 

This is usually defined as a grave disease of the 
blood, in which there is destruction of red corpus- 



94 Osteopathic Gynecology ^ 

cles. The cause is unknown and the condition 
grows worse. There is pallor, shortness of breath, 
palpitation of the heart. The patient is tired. The 
white of the eyes is pearly. The pulse is large but 
soft. There is headache and vertigo. The food is 
repugnant. The skin assumes a lemon yellow color. 
The patient becomes more feeble and the flesh more 
soft and flabby, and the bed is soon taken. Fever 
is moderate. The tendency is towards paralysis. 
The ankles swell slightly. Under osteopathic treat- 
ment the procedure is about the same as in all 
cases of anaemia. 

Treatment. The spine is to be carefully examined 
and all lesions are to be removed as fully as pos- 
sible. The treatment is general. See general treat- 
ment. The treatments must be given lightly at first, 
and as the patient improves they may be given with 
more force and at greater intervals. At first the 
treatment should be given daily, later three times 
per week. This may be reduced to twice and once 
per week as the patient improves. The treatments 
should be continued for a long time. Keep the 
heart stimulated. See Nos. 34, 43, 7C. Constipation 
and headache should be treated as indicated as 
under those general heads. 

Diet. Strict attention should be given to the diet. 
As the patient can handle it, good, nutritious food 
should be provided. See diet of tuberculosis. Let 
there be good ventilation. Out of door sleeping 
would be better. Take plenty of time for sleep. 
Keep regular hours. Exercise moderately. Give up* 



Goiter, Simple 95 

school for a time and avoid all social functions. 

Hot baths may be taken twice per week. Take a 

cold sponge bath, followed by brisk rubbing, each 

morning. 

Medical Treatment. The bowels should be given 
^ attention and should be made to move daily. In 
^ chlorosis Blaud's pills are given, which contain 
I two grains of the sulphate of iron. The pills are given 
: in increasing doses. The first week one pill three times 

per day. The second week two pills three times 

per day. Third week three pills three times per 
I day. This latter is kept up for three months. 

In progressive pernicious anaemia arsenic in in- 
. creasing doses is used. Three drops of Fowler's 
. solution three times per day is increased to five 

drops at the end of the first week, ten at the end of 

the second week and fifteen the third week. Vomit- 
^ing and diarrhoea are symptoms of an overdose. 
I Five to ten 'drops of dilute hydrochloric acid may 

he given, in all cases, in water, after each meal to 

aid digestion. 

GOITER, SIMPLE. 
(Big Neck. Bronchocele.) 

This disease is an enlargement of a whole or a 
part of the thyroid gland. The causes of this disease 
have been variously given by different medical 
writers. Those given, however, are the exciting 
or secondary causes. The disease is much more 
frequent in women than in men. The goiter in- 



9(} Osteopathic Gynecology 

creases in size at the menstrual period, and during 
each pregnancy it becomes larger. It is more prev- 
alent in limestone regions and often hereditary. 

The growth is painless, but may cause difficult 
breathing, difficult swallowing or loss of voice. It 
has caused sudden death by pressure on the vagi 
nerves. 

The outlcHDk under medical treatment is unfavor- 
able, guardedly favorable as to life, but the disease 
is generally cured by osteopathic treatment. The 
real cause of the disease is an interference with 
the nerve and blood supply of this very vascular 
gland. 

The neck should have the tissues thoroughly 
loosened, both front and back. See Nos. 1, 5, 6, 8B. 
9, 10, 11. The cervical vertebrae should be lined up 
if found out of position. See Nos. 1, 3. The clavi- 
cles should be raised. See Nos. 72, 73. Depress 
the first rib. See Nos. 75, 76, 77. But little work 
should be done over the goiter, but it may be 
raised up gently at each treatment. See No. 8B. 
In many cases a general treatment will be helpfuL 
See general treatment. Treatment may be given 
two or three times per week at first. When improve- 
ment is marked only once per week is indicated. 

EXOPHTHALMIC GOITER. 

(Graves' Disease. Basedow's Disease.) 

This disease not only presents the large neck 
(thyroid gland), but there is a protrusion of the 



Tumors and Nodules of the Breast 97 

eyeballs, a rapid heart, a peculiar muscular tremor. 
The pulse may be from 100 to 160. The breathing, 
on exertion, is difficult. 

This disease often yields quite readily to Osteopathic 
treatment. The procedure is the same as for simple 
goiter (which see). In addition to this a thorough 
general treatment is to be recommended. See general 
treatment. A wet pack may be placed about the neck 
at night. The patient should avoid excitement and 
should rest in a reclining position a great deal. 

TUMORS AND NODULES OF THE BREAST. 

These are often caused by a misplaced rib or clavi- 
cle. Lifting heavy weights or any severe work will 
produce this. When cut, cauterized, bruised or irri- 
tated in any manner these innocent growths are very 
apt to become cancerous. See the treatment for clavi- 
cles, Nos. 72, 7Z. Examine the ribs carefully, look 
for twisted ribs and ribs that are luxated in such a 
manner as to be too close together, and treat as di- 
rected under treatment for ribs. Lift up the ribs, very 
carefully. See Nos. 81, 82, 86. Give the general 
treatment (which see). Many operations may be 
avoided in this way. 



98 Osteopathic Gynecology 



THE GREAT DANGER OF NEWLY-WEDDED 
WOMEN. 

One great danger to which newly-wedded women 
are exposed is the contraction of gonorrhea from their 
mates. Of course their husbands believe themselves 
to be entirely cured of a case of gonorrhea which they 
had contracted, perhaps, years ago. But having had 
the disease they are innocent carriers of the germs, 
which, in many cases, are communicated to their inno- 
cent wives. These germs then become active in their 
new environment and begin their work of filthy de- 
struction in new soil. 

Have you not known healthy, strong, active young 
girls, after marriage to some young man, who had 
finished sowing his wild oats (as he thought), to lose 
their bright color, grow pale, weak and emaciated, and 
for years have very poor health ? You have seen these 
women enter hospitals where their ovaries and other 
organs of generation were removed.- You may have 
been told that the operation was for appendicitis, or 
was of a similar nature, for it is natural to want to 
cover these things up. But that operation is often 
not the last, and the innocent victim is not only doomed 
to a life of steriHty but to chronic invalidism as well. 

Her early death follows oftentimes. It is accompa- 
nied by long-drawn-out periods of torture, both men- 
tal and physical and the end is loathsome in the ex- 
treme. She has been sent to an early grave by one 



Great Danger of Newly-Wedded Women 99 

whom she loved and trusted and who was supposed 
to protect her from all harm. In most cases the hus- 
band is entirely innocent of premeditated injury to his 
wife. He supposes himself to be entirely cured, but 
the latent germs have become active and accomplished 
their hellish work only too well. 

Allow me to relate a case which illustrates my point. 
A. K. was a member of one of the oldest and best 
families of his community, and though a splendid 
young man was *'one of the boys." While "sowing his 
wild oats " he contracted gonorrhea, which was sup- 
posedly cured. Entering a profession he was a leader 
in it, but was handicapped by a tendency to ill health 
which was difficult for his friends to understand, as 
they knew the vigorous stock from which he sprung. 
He married a beautiful and talented girl, who, after a 
while, went to the operating table, where her ovaries 
were removed and her health was shattered. He was 
claimed by death at the age of forty, having a trivial 
ailment which most persons would have survived. 
The microscope showed the attenuated or latent virus 
of the boyhood gonorrhea, which had unsexed a moth- 
er and had accomplished its horrible mission of death 
after these many years. 

It is claimed that eighty per cent of pelvic operations 
that are performed on the women of our land are on 
account of venereal infections. There are other count- 
less thousands who suffer in silence and who are the 
prey of quacks, medical and otherwise, who are worse 
than ghouls. Venereal diseases are also responsible 
for the large increase in insanity in our country and 



100 Osteopathic Gynecology 

are often a forerunner by many years of locomotor 
ataxia and paresis. 

The reason that this disease is so difficult success- 
fully to treat in women is that the germs travel where 
drugs are incapable of following, and drugless treat- 
ment is not effective in killing the germs, which be- 
come so well established in their new centers or nests 
that any ordinary means fails to dislodge them. 

The way to overcome the horrors of the after-ef- 
fects of gonorrhea in the home would be for every 
man to be compelled to take a bacteriological examina- 
tion before he secures a marriage license, and if found 
to be infected secure competent treatment until radi- 
cally cured. This would insure more happy homes, 
less disease and more progeny from the best blood 
which the old world needs. The reason for such an 
examination will be apparent when we are told that 
four out of every five adult men have been infected 
at some time. 

The two great venereal diseases, which every newly- 
wedded woman should be protected against, are syphi- 
lis and gonorrhea. The former of these, syphilis, is 
not curable. Every once in a while some one in the 
medical profession claims to have discovered a cure 
for this '' king" of diseases, but the claim has proven 
unfounded again and again. The symptoms may not jj 
amount to very much at first, and they may be over- 
come by drug medication. But they will appear in an- 
other and worse form after awhile. All may have the 
contagion at any age, and you may rest assured that if 
you once have it you will have something that will al- 



Great Danger of Newly-Wedded Women 101 

ways stay with you, and that you will transmit to your 
children and grandchildren. When you acquire syphi- 
Hs you may expect to have the disease extend over a 
series of years and run through four stages. There 
will be the primary lesion, which comes as a sore, 
which is small and red, but gradually enlarges and 
breaks in the center, becoming a small ulcer. These 
continue about three months, when the constitutional 
symptoms assert themselves. These vary greatly. 
There may be a fever that resembles typhoid or ma- 
laria. There may be anaemia accompanied by a mud- 
dy complexion. Reddish-brown spots may occur on 
the trunk and arms, or there may be a rash that re- 
sembles smallpox. These lesions may occur at inter- 
vals lasting over ten years. At the corners of the 
mouth, in the groins, under the arms, between the toes, 
there will be patches covered with a gray-looking se- 
cretion. Persons with this disease are subject to eye, 
ear, liver and kidney diseases. In the third stage the 
ulcers continue; they are worse and leave a scar in 
healing. Gummata appear in the various organs of 
the body, which have a tendency to break down and 
form a sore, leaving a diseased condition of whatever 
organ it may affect. If the patient lives, there may 
appear, a number of years afterward, as a result of 
the poison, locomotor ataxia, or insanity, or some 
form of paralysis. The brain, spinal cord, heart, in 
fact every tissue of the body, may at one time or an- 
other be affected by this terrible disease. It is a cause 
of many of the hard, chronic cases that every physi- 
cian has to deal with, and if syphilis were a thing of 



102 Osteopathic Gynecology 

the past, with its attendant horrors, they would have 
much less work to do. Not that they treat active cases 
of syphiHs so much, but they are kept busy treating 
people of eminent respectability and position, who are 
ill as a result of syphilis which they had years ago 
and which they supposed was cured at the time; or 
it is syphilis that has been transmitted to them by their 
parents and which, if they have any offspring, will be 
handed down to them. A person who has pure blood 
transmitted to him by his parents has much to be 
thankful for. He has something far better than 
wealth and is in a condition to enjoy the blessings of 
life. He should be very careful that his children are 
allowed the same pure, healthy blood. If you have 
this dreadful disease you must remember that it is "in 
the blood " and that you can not be cured by putting 
on something or by taking medicine for several 
months. 

Do not put yourself under the treatment of a 
"quack" or so-called specialist, but go to some well- 
known physician in your own town and let him treat 
you for two or three years. He knows all there is to 
be known about your disease. No one has anything 
newer than he has got that is any good. He will know 
just how to apply strong remedies so that they will do 
the most good in your case. If you seem to be well 
and want to quit treatment let your doctor be the 
judge by all means, as he is dealing with a very des- 
perate and deceitful disease. 

While you are under treatment, during the first year, 
you should not indulge in sexual intercourse. You 



Great Danger of Newly-Wedded Women 103 

should sleep alone. All toilet articles, towels, brushes 
and shaving utensils should be used by yourself and 
no one else. Avoid kissing any one. Brush your teeth 
three times a day. Do not let any one handle any- 
thing you have had in your mouth. Do not use a pub- 
lic drinking cup. You should not marry for three 
years after you have contracted the disease, and only 
then after you have undergone a very thorough and 
protracted treatment. In fact, the State should care 
for such cases. They should be reported and should 
be dealt with as strictly as smallpox or any other dis- 
ease of like nature. 

Syphilis in infants is much worse than with adults. 
When it is hereditary they have been poisoned from 
the very beginning of their existence, and the very 
bony framework of their structure has been changed. 
About fifty per cent of them die very early, and quite 
a number never see the light of day. In some public 
institutions the mortality rate is much higher, reaching 
the appalling height of seventy per cent. So we see 
that at the very threshold of life there is a great and 
terrible danger to those who enter families in which 
there is the blood taint of syphilis. Another danger 
that they run is in acquiring the disease. While the 
number of these is not so great as those who inherit 
the disease, there are still quite a number of them ; and 
many who are said to have a case of '' late hereditary 
syphilis" have acquired the disease because of the 
carelessness of others. They may get the infection by 
the kiss of another syphiHtic child or older person, or 
by using the playthings of one who has the disease. 



104 Osteopathic Gynecology 

They may acquire it from servants, nurses, parents; 
and even a careless physician has been known to 
spread the disease. It is not so terrible as the heredi- 
tary form, as it has not commenced its work until the 
child has had an opportunity to develop some. Yet it 
should receive a very thorough course of treatment. 
Those children who are not aborted or born dead as 
a result of the disease may have a very severe infection 
and die in a few days. Others may appear to be healthy, 
yet the symptoms appear in from one to eight weeks. 
If no symptoms appear for three months the child 
may be considered safe. The symptoms at first are 
similar to a cold in the head. It is catarrhal in nature 
and very severe and persistent. There is blood in the 
discharge and thick crusts form. The child breathes 
through the mouth and finds it very hard to nurse. Its 
cry is hoarse. The child's early teeth decay rapidly 
and the second set have a notch in the cutting edge. 
Later the bridge of the nose may have a tendency to 
fall in. The child may have eye and ear trouble, a 
saber-like deformity of the tibia or shin bone, enlarge- 
ment of the spleen and other glands. 

The best and easiest way to avoid this trouble is for 
a person who has syphilis never to marry. But the 
best way is to be clean and never acquire the disease. 
It would be well, if you are a young woman, to be ab- 
solutely sure that your intended has never had syphilis, 
and so avoid the possibility of going through a living 
'' hell " on earth. There have been efforts made in 
various States to pass laws requiring the registration 
of venereal diseases. This would be desirable, as it 



Great Danger of Newly-Wedded Women 105 

would be easier to avoid. But it has not been possible 
to have such legislation enacted. There should be com- 
pulsory examination of all who intend to enter the 
marriage relation. 



106 Osteopathic Gynecology 



THE CLIMACTERIC. 

A very trying and usually a very dangerous time for 
women to pass through is about the age of forty-five, 
though this may vary considerably. It may be as early 
as thirty-five with some and as late as over fifty in 
others. When a woman is strong sexually she begins 
to menstruate early in life and continues to do so until 
much later in life than one who is weaker. If you are 
in a good, healthy condition you may not fear the 
change of life, for we have known such persons to go 
through with it and hardly know the difference. But 
if you are subject to organic disease it will be apt to 
show its full effect at that period of life, for the vitali- 
ty with which we begin life and which we have added 
to or spent as the case may be, is diminishing from 
natural causes and we have but little to draw upon, 
and so the organic disease, whatever it may be, gets 
the upper hand. 

The change of life lasts with most women from one 
to two years; sometimes it drags along several years 
and may last for five or ten years. Wasting disease 
bring on an early change and it is continued longer. 
Either physical or mental shock, which unfits a woman 
for childbearing, does the same, and chronic inflam- 
mation of the uterus predisposes to an early change 
of life, which is fraught with various disturbances. 

The changes that take place are due to the ovaries 
ceasing their functions. This causes the uterus to be- 



The Climacteric 107 

come small and hard. The vagina becomes pale and 
shorter and smooth. The sexual feelings are gradual- 
ly lost ; the breasts usually become smaller and flatter, 
but in case the size is retained the glandular parts are 
replaced with fat. About eighty per cent of such 
women become obese, but in some there is a loss of 
flesh. There is a tendency to cancer and other malig- 
nant growths at this time. 

The first symptom of the approach of this change of 
life is irregular menstruation. It is usually delayed, 
coming on at the fifth or sixth week, or it may come 
at any time. The amount of blood passed varies, 
sometimes less, sometimes more, but it is generally the 
latter, and frequently amounts to a hemorrhage. 
There are times when the flow is so great as to threat- 
en the life of the patient, when we should suspect a 
cancer. The flow is also prolonged, lasting at times 
for from seven to ten days, and in a few cases for as 
many weeks. But this is an abnormal condition and 
we should be on the lookout for a case of malignant 
disease. Frequently there is a cessation of the menses 
for several months, but coming on again after an exer- 
tion. Should they have stopped suddenly from any 
unnatural cause, such as a cold, the person will not 
feel well until they again appear. 

There are also reflex symptoms of a varying nature 
accompanying the menopause : palpitation and slowness 
of the heart, also difficult breathing. There are hot 
and cold flashes. With some they occur about every 
hour. It feels as if the blood were leaving the body, 
when they suddenly feel the blood rushing over the up- 



108 Osteopathic Gynecology 

per part of the body, and the face becomes very red 
and the heart is apt to beat very hard. The eyesight 
is affected and there is a roaring in the ears. A part 
of the body, usually an arm, feels numb, and the sleep 
is disturbed. Piles, if any, are given to bleeding very 
much at this time and the mucous membranes of the 
body are congested, resulting in a catarrhal condition. 
Insanity may be the trouble in some cases and a marked 
hysteria in others, and in some the whole disposition 
is changed. 

While cancer of the uterus and breast is liable to 
begin at this time, the menopause cures a great many 
other diseases, so that some women are better in health 
than they were before this took place. Ovaries which 
caused a great deal of pain do so no longer. Painful 
and difficult menstruation has passed and various in- 
flammatory conditions cease. A woman who may be 
contemplating an operation for tumors about this time 
should wait, by all means, until after the menopause, 
for they often disappear entirely on account of lack 
of nourishment. Goodal, the gynecologist, says that 
in his practice over forty tumors of a stony hardness 
were entirely absorbed. 

Treatment. We do not expect to cure these dis- 
turbances, but much may be done to relieve such con- 
ditions by following the treatments outlined in the sec- 
cond part of this book. For too profuse and prolonged 
menstruation, the patient should take to bed; if not 
convenient to do this, keep off the feet, as walking 
tends to congest the uterus. When the patient wishes 
the flow to cease and when it is causing weakness the 



The Climacteric 109 

foot of the bed should be made higher than the head. 
She should be kept quiet, both mentally and physically, 
for worr}^ tends to make the disease worse. The ob- 
ject in treatment is to get the uterus to contract, and 
we may do this by stimulating the, nerves that go to 
it, which may be accomplished by strong manipulation 
in the lumbar and sacral regions of the back. See 
Nos. 57, 58, 59, 60, 64, 65, 66, 68, 69, 47, 48, 49, 50, 
52, 43, 44. You may use deep, circular massage over 
the uterus. Something hot or cold placed on the lower 
part of the abdomen w^ill shock the patient and pro 
duce a contraction of the uterus, as will a sudden jerk 
of the hair on the mons Veneris. A good slapping of 
the buttocks, taking the patient by surprise, will also 
produce the same results. For the nervous system 
use the treatment outlined here. The patient lies re- 
clining on the side. The tissues of the back are loos- 
ened, as indicated in Nos. 53, 56, 58. The shoulder 
is manipulated as in 54, 55, and the lower limb is mas- 
saged while in this position. The spine is sprung from 
. one end to the other, as in No. 57. The patient takes 
the reclining position and further treatment is given 
the back as in Nos. 47, 48, 50, 51, 52. 

Afterward the patient lies on the back and the treat- 
ment is given on the head as in Nos. 14, 15. The 
neck is treated as in Nos. 7B, 9, 10, 11, 13. The arms 
are given a pretty thorough massage. Further treat- 
ment is given the back and the ribs are raised as in 
Nos. 61, 62, 64, 86. The abdomen is treated as in Nos. 
94, 95, 96, 100, 101, 102. The lower limbs are further 
massaged and flexed with pressure on the abdomen. 



110 Osteopathic Gynecology 

The patient now sits and the back and spine are fur- 
ther treated as in Nos. 1, 2, 5, 34, 36, 37, 43, 44. 

For the heart difficulty, when there is a rapid pulse 
and it is perceptible to the patient, the left hand may 
be held above the head and a steady pressure be 
brought to bear on the second to fourth spinal dorsal 
vertebra. Continue this for five or ten minutes. See 
No. 67. Raise the ribs. See Nos. 82, 86, 87. Give a 
deep, inhibitive abdominal treatment for the purpose 
of relaxing the caliber of the abdominal vessels and 
drawing the blood there, thus quieting the heart's ac- 
tion. See Nos. 94, 95, 100. Stimulate the pneumo- 
gastric nerve. See No. 7. Raise the clavicle. See 
Nos. 72, 73. Apply an ice bag over the heart. Should 
the atlas or axis be out of position, correct. See Nos. 
1, 3. Loosen the upper spinal muscles. See Nos. 34, 
43, 53. This treatment may be given about three 
times per week. 

Women at this time of life are subject to tumors 
and nodules of the breast, which are often mistaken 
for cancer, but are innocent tumors caused by an ob- 
struction to the circulation on account of a misplaced 
rib or clavicle. See treatment for clavicles. Nos. 72, 
73. Examine the ribs carefuly, look for twisted ribs 
and ribs that are luxated in such a manner as to be 
too close together, and treat as directed under treat- 
ment for ribs in the second part of this book. Lift 
up the ribs. See Nos. 81, 82, 86, and treat as before 
mentioned for nervous symptoms. Many operations 
may be avoided in this manner. 

Obesity is a trouble that comes at this time of life. 



The Climacteric 111 

that is not only a great inconvenience but may serious- 
ly impair the health. The fat infiltrates the heart 
muscles and greatly weakens them ; also the lungs, liv- 
er, kidneys and blood vessels. The controlling factors 
that cause this trouble may be heredity, bad habits of 
eating and drinking, lack of exercise, and spinal le- 
s.ions that interfere with the proper working of the 
liver, pancreas, and lymphatic system. 

This condition must not be overcome too suddenly, 
but remove all lesions as soon as possible. The clavi- 
cles are to be raised and the first ribs lowered. See 
Nos. 72, 73, 75, 76. A thorough spinal treatment 
should be given for the stimulation of the liver, pan- 
creas and kidneys. See Nos. 32, 43, 57. Give a vig- 
orous treatment over the fat, as this tends to absorp- 
tion. Give the treatment before outlined for nervous- 
ness. 

The diet should be greatly restricted. Starches, 
fats, and sweets are to be eliminated as much as pos- 
sible. The use of water is to be restricted, and alco- 
holic drinks are to be prohibited. Regular exercise 
must be taken. If the heart is weak begin moderately 
and gradually increase the exercise. Walking is very 
beneficial. A sample diet list follows. It is known as 
Erbstiens.' He allows three meals per day. Break- 
fast will consist of a cup of black tea without sugar or 
milk. Also two ounces of buttered toast. For dinner 
one would have a meat soup, four to six ounces of fat 
beef, roasted, or fat beef with gravy, but not thickened ; 
a small portion of two fresh vegetables, and for des-^ 
sert, salads and fresh or dried fruit ; tea without milk. 



112 Osteopathic Gynecology ; 

Supper, an egg with an ounce of buttered toast, some 
cold fat meat and some fruit. The water taken is re- 
stricted. All drugs taken as anti-fat remedies are 
dangerous. 

A person who is going through this period of life 
should be as contented as possible. Look for the 
bright side of everything. Be happy and cheerful. It 
may require an effort, but a peaceful mind means a 
great deal for these conditions. Be out of doors as 
much as possible and have your sleeping rooms well 
aired. Fresh air and sunshine will be very helpful. 
Seek the company of young people and take an inter- 1 
est in them and their pleasures. We have known 
women who were in poor condition during this time 
to be better after the ordeal than they were before, 
and to enjoy life as they never had. 



Young Children 113 



YOUNG CHILDREN. 

The first and second years of a child's life are the 
most prolific of dangers, and the greatest one to which 
they are subject is that of the various diarrhoeas. The 
extreme susceptibility of that early age is shown by a 
record kept in New York city, where the deaths from 
this disease with children under two years of age ex- 
ceeded the number of those of all ages who died of 
measles, scarlet fever, whooping cough, typhoid fever 
and diphtheria. 

One reason for this is that the intestinal tract has 
great demands upon it for the needs of the developing 
body, and its mucous membrane is so delicate that it is 
constantly exposed to various forms of irritation and 
to different infections. The trouble is very largely in- 
creased in the summer months, the extreme heat of 
which has a very devitalizing effect on the children. 
It is shown that this acts independently of other 
causes, because the diarrhoeas occur everywhere in the 
temperate zone among all classes of children. 

To overcome the liability to these diseases one 
should keep their clothing and bodies perfectly clean. 
Flies should be kept away from them and their food, 
as they are great carriers of germs which produce dis- 
ease; and anything which lowers the vitality of the 
children increases the liability to diarrhoea. For this 
reason they should have sufficient rest and plenty of 



114 Osteopathic Gynecology 

fresh air. If they are dwellers in the city let them 
spend the warmer months in the country. A day at 
a time will be better than no time at all. The milk 
from the mother is the best, and if this is impossible, 
milk which has been properly prepared should be giv- 
en at regular intervals. 

There may be several other causes for this trouble, 
one or more of which may be present: (1) Indigesti- 
ble, overripe or green fruit. (2) Sudden changes in 
the weather temperature. (3) Poisons generated in 
the food, as in milk or ice cream. (4) Nervous symp- 
toms resulting from the emotions, as fright. (5) 
Various diseases, as cholera, t3^phoid fever, tuberculo- 
sis, etc. (6) Predisposing causes, as anatomical de- 
rangements of the spine. 

Treatment. If the disease arises from either of 
the first three causes enumerated above, a dose of cas- 
tor oil, followed by an enema, is indicated. This 
should be followed by a relaxation of all the tissues 
of the spine and back. See paragraphs Nos. 34, 36, 
43, 48, 57, 58. In the case of young children the tem- 
perature should be regulated with water; if too high, 
by baths ; if too low, by hot water bags. The bath for 
reducing fever should last for ten or twenty minutes 
and should be given often. An ice cap may be applied 
to the head. The pain and colic may be relieved by 
strong continuous pressure above the small of the 
back. See paragraph No. 67. The child may be 
lifted well off the bed by clasping the hands beneath 
the back where we desire the pressure to be made. 
Hold for a minute or two. Pressure above the sacrum 



Dangers of Puberty 115 

will stop cramps in the legs. An ice bag applied there 
and to the lower lumbar regions of the spine will do 
the same. 

DANGERS OF PUBERTY. 
(Boys.) 

Boys from fourteen years of age and upward are 
exposed to a peculiar danger. This is because they 
then attain sexual maturity, or what is known as pu- 
berty, which is accompanied by many changes in dif- 
ferent parts of the body. Hair is now to be found 
growing on the pubes and genital organs, and it is 
more abundant under the armpits. The boy's shoul- 
ders broaden and his voice becomes deeper. His lar- 
ynx grows perceptibly larger, as well as the organs of 
reproduction. These organs of reproduction become 
physiologically active. Erections of the penis occur 
and seminal fluid is secreted in the glands. As these 
changes take place he may have voluptuous dreams 
and with them involuntary seminal emissions. As 
some prominent writers would view this subject these 
emissions, if not unnaturally provoked, are not in- 
jurious or harmful, but are entirely physiological and 
natural within certain limits. 

Quack advertisers make much of this, and knowing 
that many young men know but little of this subject, 
and in many instances are too bashful to speak of it 
to those who know, they try to alarm them as much as 
possible and persuade them to take treatment. We 
have seen statements from them to the effect that such 
young men were in danger of idiocy and impotence*, 



116 Osteopathic Gynecology 

that they would grow weak and nervous and that the 
organs of reproduction would grow very much smaller. 
They tell us that a seminal emission is equal to forty 
times the amount of blood drawn direct from the 
heart. They picture it as bad as they possibly can in 
order that the young men may be drawn into their net, 
and when there they will " bleed " them as much as 
possible and keep them in their toils as long as they 
can. 

This can not be considered other than natural 
unless it occurs too frequently, when you should con- 
sult your family physician. You may diminish their 
frequency by bathing the parts in cool water, by sleep- 
ing in a bed that is hard and not too warm. You 
should not eat stimulating food and should avoid con- 
diments. Do not overeat. Avoid the reading of im- 
pure books and literature and keep good company. Be 
much in the open air and take plenty of exercise. Do 
not think of sexual matters. It may be that there are 
anatomical misplacements of the lower spine which ir- 
ritate the nerves that supply the sexual organs, and 
if so they should be corrected. They may be inhibited 
by using treatment, paragraph number 67. 



Dangers of Men Over Forty 117 



DANGERS OF MEN OVER FORTY. 

There is a danger to which men about forty years of 
age or over are liable, and which will carry them off 
with but little warning and in many cases with none 
at all. The danger to which I refer is arterio-sclerosis, 
and is commonly spoken of as hardening of the arter- 
ies. It is sometimes called degeneration of the blood 
vessels. 

When over the age of forty it is well not to do 
anything requiring severe physical exertion. Do not 
run for a street car, as you will be apt to rupture one 
of the blood vessels if they are at all weakened. The 
cerebral arteries of the brain are sometimes broken 
and often cause instant death, and in many other cases 
result in paralysis of one entire side on account of 
blood pressure on the brain. Any artery may be rup- 
tured, and it is my purpose to give such directions as 
will reduce the danger to the minimum. 

Long life is largely a vascular question, and it has 
been well expressed by an axiom : "A man is only as 
old as his arteries." To a vast majority of men death 
comes through this gateway. Among the causes may 
be mentioned: 

The High Pressure of Modern Life. There are 
many men who have attained the age of over forty 
years who have not done many of the things that ordi- 
narily lead to this trouble. They have been temperate 
in eating and drinking; they have not contracted any 



118 Osteopathic Gynecology 

venereal diseases ; they have not had gout, but never- 
theless they have arterio-sclerosis, which has come as 
a result of high pressure of living. They have been at 
a high tension attending to business all day, with its 
keen competition, and at its close, after a strenuous 
time getting home, have only time to effect a change 
of clothes, when they are doing the society act and do 
not retire until late, not taking sufficient time for 
needed rest. They find themselves at last with some 
form of kidney trouble or with hardened arteries. 

Overeating is another cause of hard arteries. 
There are many cases of that trouble for which there 
are no other causes. Men really dig their graves with 
their teeth. We may harm ourselves by being intem- 
perate in our eating as well as partaking of intoxicat- 
ing liquors. We need the advice of that old-time 
physician. Dr. George Cheyne, who said : " Every 
wise man, after fifty, ought to begin to lessen at least 
the quantity of his aliment, and if he would continue 
free of great and dangerous distempers and preserve 
his senses and faculties clear to the last he ought, 
every seven years, to go on abating gradually and 
sensibly, and at last descend out of life as he ascended 
into it, even into the child's diet.'* 

This advice, if followed, would ward off a number 
of diseases, including stomach troubles, obesity and 
kidney diseases. 

Chronic Alcoholism, gout and lead poisoning are 
also important factors in causing this disease. They 
change the quality of the blood and this in turn affects 
the arteries. They also set up renal changes which 



Dangers of Men Over Forty 119 

affect the blood and arteries as well. In most persons 
alcohol conserves the fat, and this infiltrates in the 
walls of the blood vessels and weakens them, allowing 
the blood to force its way through. 

Prolonged Muscular Exertion is a cause. This 
hardens the arteries by raising the peripheral resist- 
ance, thereby increasing the blood pressure, which 
gradually weakens the arteries. 

I will now speak of undue blood pressure in the 
brain as a cause of apoplexy and give my reasons and 
the remedy for this condition. The brain is a great 
storehouse of energy and nerve force. From it ema- 
nate thousands of nerve fibers, controlling every func- 
tion of the body. This great work on the part of the 
brain requires an enormous amount of nutrition and 
elimination. Especially is this the case when the man 
is a brain worker. This brain nourishment is con- 
veyed through the arteries, veins, capillaries, lymphat- 
ics and serous channels which reach the head through 
the neck. We find surrounding the neck vertebrae 
more than thirty muscles, together with ligaments. 

In and between these muscles lie the arteries and 
veins that convey the blood to and from the brain. 
The blood is pumped under direct pressure of the 
heart through the heavy walls of the arteries. But the 
return blood through the veins, which have soft, flab- 
by walls, is under light pressure and may be held back 
by obstructions in the neck until undue pressure is ex- 
erted by the blood of the brain. This pressure often re- 
sults in the rupture of capillaries, which means sudden 
death or apoplexy and paralysis, depending on the 



120 Osteopathic Gynecology 

amount of blood escaping into the brain tissue. In 
young persons the capillaries are more elastic and will 
not rupture as with older persons. 

When there is normal relaxation of the muscles of 
the neck there is normal circulation to and from the 
brain. When there is maladjustment of the vertebrae 
of the neck, pinching the nerves and contracting the 
muscles, the return flow from the brain is impeded, 
while the heart is still forcing the blood under increas- 
ing pressure through the arteries to the brain. This 
causes heavy, expanding pressure in the capillaries of 
the brain tissue. The blood can not return fast enough 
through the veins on account of interference in the 
neck. The pressure rises higher and the capillaries 
break, the oozing blood forms a clot and apoplexy is 
the result. Overexertion, a little excitement, brings 
on the attack without the least warning. 

Prevention is the only remedy, and the best way to 
apply this is properly to relax the neck muscles and 
keep them free from all contractions, and the verte- 
brae from all maladjustments. This may be done by 
giving the proper treatment, which is as follows : Fol- 
low paragraphs 1, 3, 5, 9, 11, and 13 in the second part 
of this book. Also use inhibitive pressure on the ab- 
domen as in paragraphs 94 and 100. This tends to draw 
the blood there and away from the head. 



How to Secure a Male or Female Child 121 



HOW TO SECURE A MALE OR A FEMALE 
CHILD. 

(The Determination of Sex.) 

Before treating this important subject it will be well 
to understand something of the minute structure of 
the ovaries and how they perform their functions. 
Each ovary is made up of an outer and an inner part, 
called the cortical and medullary substances. The cor- 
tical substance, or outer part, is formed of columnar 
epithelium, a layer named albuginea, and under this a 
layer of the parenchyma. The medullary portion is 
very vascular and is made up of very loose connective 
tissue and unstriped muscle fiber. 

In the cortical portion are found the Graafian fol- 
licles. These follicles contain the ova, or human eggs, 
just large enough to be seen by the naked eye. These 
follicles gradually work their way to the surface of 
the ovary and bursting there at the menstrual time al- 
low the ovum to escape and find its way into the Fal- 
lopian tube, thence into the uterus. In discharging 
the ovum in this manner the ovary is left with a scar 
on its surface, by means of which we have one way of 
proving that the ovaries take turns in performing their 
functions, which allows each one to ovulate every two 
months. The ovum comes first from the right ovary 
and then from the left. This is also known to be a 
fact because a woman suffering from a painful affec- 
tion of an ovary at the menstrual period has the pain 



122 Osteopathic Gynecology 

and distressing trouble only every two months. Again 
in some cases pain occurs in the mammary gland on 
the same side that contains the ovary which is ovulat- 
ing, and this pain changes from one side to the other 
every month. Gynecologists have noticed that first 
one ovary becomes larger and then the other, at each 
successive menstrual period. This is on account of 
the ovary bursting at the surface to release the ovum. 
In operations and autopsies one ovary is found ready 
to discharge its ovum while the other ovary is prepar- 
ing for that function. In women who were known to 
have menstruated a certain number of times, say 
forty, there would be found twenty scars on each 
ovary, proving that each one had furnished an ovum 
every two months. In the cases where women have a 
double uterus and a double vagina we find that the 
menses come first from one side and then from the 
other side on alternate months. These facts have oc- 
curred over and over again, proving that each ovary 
throws ofif an ovum every two months. 

The ova are thrown off from the ovary with the sex 
already determined. The right ovary producing male 
eggs and the left ovary female eggs. This is proven 
in a variety of ways. When for any cause one ovary 
is removed the other produces eggs of but one sex. 
This has occurred in a number of instances. When the 
left ovary was removed none but male children were 
born, and when the right one was removed none but 
female children were born. When there exists a 
cause for steriHty on either side we expect but one sex 
in the children. 



How to Secure a Male or Female Child 123 

The husband in no case has any effect on the sex of 
a child. All that the male does is to impregnate the 
ovum. There are a number of cases on record where 
a woman having been married twice has had only 
children of one sex. There are also a number of cases 
where men, having been married two or three times, 
by the first wife would have all boys, and from the 
union with the second wife only girls would be the re- 
sult, and as a result of a third union there would be 
boys alone. 

As the spermatozoid from the male is capable of 
living for weeks in the Fallopian tubes of the female, 
it has been said that the woman may help to control 
the sex of the unborn child by lying on one side or 
the other for some hours, and thus influence the 
spermatozoid to enter the desired tube, where it will 
be met by an ovum of the sex she wishes for. 

When the menstrual period is regular and lasts for 
a certain number of regular days, and a boy or girl 
has been previously born, and it is known when the 
menses appeared after such a confinement, such par- 
ents may determine the sex of a child yet unborn. 
They may also determine the sex of all future children 
born to them. Always remember that there are thir- 
teen menstrual periods or ovulations per year, and 
when a boy is born in January, a girl may be expected, 
if a child is born, on the following January, or a boy in 
February. 



124 Osteopathic Gynecology 



HOW TO HELP MEN RESPECT MARRIAGE 

VOWS. 

It is a well-known fact that there is a great deal of 
marital unrest and unhappiness. The divorce court 
is being appealed to, marriage vows are annulled and 
many homes are wrecked. There seems to be a grow- 
ing disregard for the sanctity of the marriage relation, 
more particularly on the part of men who have 
reached the age of forty. May there not be some 
great natural law that is being violated? Are these 
men wholly to blame for their shortcomings? False 
ideals on the part of many wives are greatly responsi- 
ble. They regard the manifestation and gratification 
of the sexual desire as immodest and highly unbecom- 
ing to their sex. Sexual desire has been suppressed in 
their lives for generations, and in some cases has been 
so pronounced as to be inherited by their male de- 
scendants, who have been impotent and have an aver- 
sion for the sexual act. Women are still repressing 
sexual feelings as their mothers did before them. This 
is developing into heredities and rapidly fitting women 
to live a false standard. It is the normal thing for 
women to have sexual desires and they should cultivate 
them instead of repressing them. When women reach 
the menopause, or change of life, their sexual appe- 
tite decreases naturally, as the sexual organs atrophy 
and become less active. If this desire were to be culti- 
vated as these later years approach there would not be 



Help Men Respect Marriage Vows 125 

such a wasting in the sexual organs and the woman 
would be better fitted for her duties as a wife. As it 
is most women take less and less interest in sexual af- 
fairs after the menopause and many are filled with re- 
pugnance at thought of the sexual relation. They 
suffer the act, but take no active part in it, and are 
glad when it is finished. Normally, sexual power and 
desire should be equal in the sexes. Both should strive 
to minister to the other, and unless there is mutual 
pleasure in the act neither is fully satisfied. 

A lady, sometime ago, asked of a physician why it 
was that so many men live clean, moral lives until they 
pass the divide, and then when they start down the 
other side their moral life goes the downward way at 
the same time. This physician happened to know that 
her husband, who was a prominent man in the com- 
munity, whose life had been of the average, a pretty 
good man, had lately taken to associating with certain 
of the lewder, '* fast" women of the town, and had 
been so open in his relations with them that even the 
older boys had recognized the condition, and his inti- 
mates were wondering how soon he would carry a cane 
to ease an unexplained sprain. The doctor surmised 
that she understood conditions and asked whether she 
wanted him to speak in general platitudes or to be 
brutally frank and explicit. On expressing her desire 
for a full explanation he told her that false ideals were 
at the bottom of all this misery, which is far more 
common than is generally believed. He told her that 
man's sexual powers seemed to wane when they were 
about forty years of age, as it is much more difficult to 



126 Osteopathic Gynecology 

obtain satisfaction without full cooperation, and being 
met with apathy and indifference on the part of the 
wife, when he mostly needed her ministrations of the 
nuptial contract, he naturally would be tempted to 
seek fresh pastures. 

This conversation is so apt on this subject that we 
will reproduce a part of it here. She interrupted him 
by saying : '' You are like all the men. You hark 
back to Adam and try to throw all the blame onto the 
woman's shoulders." 

She was a notable housewife; her linen was the 
most dainty; her silver and china irreproachable, and 
her menus ever gave some pleasant surprise to her 
many guests. 

The doctor said to her : " You are noted for the 
elegance of your table. Suppose that your husband 
should come home weary and hungry and you should 
go to the pantry and snatch a handful of this, that and 
the other, throwing all pellmell into a pan, and after 
pouring coffee over the mess, you were to slam the 
pan onto the table with the remark ^ There's your sup- 
per/ or were to say to him, ' If you want anything, 
go the pantry and help yourself.' If you were to do 
this how long do you suppose your home would re- 
main harmonious ? " 

"Why, he'd have me before an insanity commis- 
sion," was her wondering answer. 

" You would not blame him if he were to eat at a 
hotel or restaurant ? " 



Help Men Respect Marriage Vcws 127 

" Indeed, no ; but I don't comprehend what you 
mean/' 

Then the doctor told her that there are two great 
appetites which rule the world : the food desire, which 
preserves the individual, and the sex hunger, which 
perpetuates the race. Both are proper as well as nec- 
essary. The evolution of our civilization has placed 
the former on a high, esthetic plane, and relegated the 
other to an unmentionable degradation. And there is 
so much false modesty and prudery manifested with 
this subject that one has to be extremely careful in 
writing about it for fear of offending some one. There 
is a God-given sacrament, marriage, which is at the 
basis of the home, upon which our life system is built, 
and yet the sexual relationship, which was designed 
for the procreation of our descendants, must not be 
discussed. It is not nice to talk about or even to think 
of. 

The doctor then told the lady : '' The wife who 
probably all through her married life has failed in her 
nuptial duty to her spouse, when his danger period ap- 
pears, becomes more lax. When he most needs her 
ministrations to protect him from himself, then she 
sets his nuptial table with scanty, cold scraps, or with 
absolute passivity; suffers him, perhaps with expres- 
sions of loathing, to * help himself.' '' 

"What should she do?" 

The doctor answered that the courtesan presented 
every possible blandishment and charm that nature 
and art may teach her to cater to her business, pre- 
cisely as the hotel serves food in an enticing manner. 



128 Osteopathic Gynecology 

and the true wife should keep her husband by the ex- 
ercise of the same care in feeding one appetite as the 
other. 

She became indignant. " You would have the re- 
spectable woman resort to the wiles of the strumpet?" 

*' Indeed, yes ; eliminating the brute grossness, and 
adding all that womanliness may be or know." 

The act, controlled and pure, actuated by love rather 
than by brute passion, is the purest, sweetest and love- 
liest relation known to mankind, and should be ap- 
proached with reverential attitude, and the determina- 
tion of both that it shall be full to completeness and 
perfection. 

After her duty was fully explained the doctor was 
much gratified to note, ere long, that her husband no 
longer consorted with lewd women. 

This doctor's prescription was one that will com- 
mend itself to the person who does not believe in 
drugs. It was advice that saved a home; it removed 
an atrophy of function and established a physiological 
action of certain organs ; hence it fell within a proper ' 
scope of his practice. 

The sexual act may be bestialized in precisely the 
same manner as the food appetite. Contrast the sav- 
age, striking down his victim, and rending with teeth 
and nails, with the courteous gentlemen, with all the 
refinements of society, as he partakes of an elaborate 
banquet, while music and flowers and soulful compan- 
ionship add to the delights of the repast. 

As a race we have developed to the utmost the 
amenities of the table, while in the main we have 



Help Men Respect Marriage Vows 129 

relegated the more important function to ignominious 
disregard as something " not nice to discuss." 

With many men the traditions of the ages, which 
caged the woman in a harem and regarded her as the 
mere passive agent of their lusts, still remain ; indeed, 
the conventional double standard of today is but the 
physical barrier replacing the cruder bars of the ha- 
rem. This is the theory which tacitly winks at im- 
morality of the man, and utterly condemns his sister 
for a suspicion of lapse from the walks of virtue. 

Very few of those who enter the marital relation 
have the proper conception of the manner of proced- 
ure, or accomplishment or purpose of the sexual act, 
and their ignorance leaves them to pass through life 
with no more of the esthetic and humanizing element 
of the relation than the savage who greedily rends his 
food. 

The pair should approach the nuptial altar with a 
clear, full idea that the act is perfectly proper, free 
from grossness and animalism. Each should come 
filled with a desire to minister to the other." This ac- 
cords with the priest of old, who, ere, approaching the 
altar, purified himself and garbed himself in spotless 
garments, typical of his mental and spiritual attitude. 

The act should be leisurely performed, and the same 
calm decorum should be maintained as at the table 
when the other appetite is appeased. There should be 
no undue haste, and the entire process should be char- 
acterized by gentleness and considerateness. 

On the other hand, where the act is performed vio- 
lently and precipitately, it leaves a sense of irritation 



130 Osteopathic Gynecology 

and desire that will demand further and further ap- 
peasing and fails to satisfy. This violence, with its re- 
sulting excesses, is one of the principal causes of " lost 
manhood/' The man has simply burned out and ex- 
hausted his batteries. A man who has learned to per- 
form this act properly, and who can approach it in the 
true attitude, is thoroughly protected in the walk of 
sexual purity and virtue. Having learned the ethics 
and practice of such a plan as I have here described, 
the wiles of the common drab no more tempt him than 
do the female animals in the barnyard. 

The element of reciprocal love is as necessary to the 
enjoyment and satisfaction of the act as is the other 
party to the act. Without this element it becomes but 
little better than an act of masturbation. Under prop- 
er conditions the sexuality of the two sexes should be, 
and I believe is, properly balanced. 

From what has been said here about this sacred re- 
lation any woman who has been remiss in her duty to 
her conjugal partner can, if she desires, rectify the 
mistake and build her house, not upon the sands, but 
upon the rock. The knowledge and practice of sane 
and scientific methods would cement many a broken 
home, heal many an aching heart. In every communi- 
ty many homes are found in which conditions are not 
what they were in the Garden of Eden, because of 
ignorance and carelessness of the sexual relationship 
therein. Proper instruction could remedy many of 
the ills of rhany such places. 



The Laxus-Cycle 131 



THE LAXUS-CYCLE. 

The object of the following pages is for the purpose 
of instructing patients to treat and cure themselves. A 
great part of the treatment may be taken at home and 
an occasional visit to the office of a doctor to treat 
special lesions which may exist. This mode of proced- 
ure will be found very helpful in chronic cases which 
require a long and patient course of treatment. Again, 
there are those who, being well, desire to keep them- 
selves in the highest state of physical well-being. 

Doctors recognize the great fact that abnormality 
of structure is often the cause of disease. This abnor- 
mality may consist in misplaced vertebrae or viscera, in 
contractions of the muscles or ligaments and, in fact, 
any deviation from the normal, either in contraction or 
misplacement of any organ or tissue. Most of these 
deviations are found in the spine and are the most 
prolific cause of disease on account of the situation of 
the spinal cord, the great central trunk of the nervous 
system. 

It will be found that the Laxus-Cycle will correct 
deviations from the norma} in the spine, such as con- 
tractions, curvatures, anterior or posterior displace- 
ments, and can be used for making pliable all the tis- 
sues of the back. For assisting the circulation it may 
be used on all parts of the body. It may be used in a 
very thorough manner for the purpose of applying 



132 Osteopathic Gynecology 

stimulation or inhibition to the nerves, a very impor- 
tant manipulation procedure. 

In using the Laxus Cycle in the treatment of dis- 
orders peculiar to women it will be well to bear in 
mind the following centers : 

Anus and Bladder The Sacrum 

Bowels 9th, 10th, and 11th Dorsal Vertebrae 

Genitals From 2nd Lumbar to end of Spine 

Intestines 4th Dorsal to 2nd Lumbar 

Legs 11th Dorsal to 2nd Lumbar 

Ovaries .... 9th Dorsal to 2nd Lumbar Vertebrae 

Rectum Lower Lumbar Vertebrae 

Uterus 2nd Lumbar Vertebrae to Sacrum 

If it is desired to inhibit the nerves, or quiet them, 
steady pressure will be made on these centers with the 
Laxus-Cycle as in Fig. Nos. 3-6. When we wish to 
stimulate the nerves we work over the nerve center 
with the Laxus-Cycle as in Fig. Nos. 8, 9, 10. 

The entire Laxus-Cycle is shown in Fig. 1. In Fig, 
2 it is shown spread out on the table or floor for the 
purpose of taking a gentle treatment, which is accom- 
plished by propelling the body up and down on the 
apparatus by the assistance of the limbs as in Fig. 3. 
If one desires to give an inhibitive treatment, just rest 
in one place as indicated for about ten or fifteen min- 
utes. Fig. No. 4 shows the Laxus-Cycle adjusted for a 
harder treatment and Fig. No. 5 shows it arranged for 
a severe treatment which is illustrated in Fig. No. 6. In 
Fig. No. 7 we see the machine divested of its running 
box and the handles inserted for giving the treatment 
as in figures 8, 9, and 10. The rollers are made of 



The Laxus-Cycle 133 

specially-prepared rubber of great resiliency, and are 
peculiarly adapted for the purpose. This machine is 
patented and will be furnished by the author, who will 
furnish simple instructions for the treatment of all 
diseases. 




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144 Osteopathic Gynecology 



OBSTETRICS. 

Although nature has adapted women to bring forth 
children without any other assistance than that af- 
forded her by her own inherent powers, still it has 
been found agreeable to her to have assistance at this 
time. This help has been given for so long that it is 
regarded as necessary. It is my intention to give a 
few simple instructions and not to cover the whole 
field. Osteopaths do not believe in interfering too 
much with nature. The whole trend of the treatment 
should be to assist and let nature take her course as 
far as possible. An Osteopath should never take 
charge of an obstetrical case if he has care of scarlet 
fever, erysipelas or any contagious disease and in a 
case of this kind he should never be in a hurry, as he 
should not be prone to help things along with the aid 
of forceps. 

A case of this kind would be greatly benefited if 
it was osteopathically treated for a month before con- 
finement and it should have osteopathic attention until 
all danger of bad after effects are over and it was cer- 
tain that no lesions existed as an effect of the deliv- 
ery. The hands should be thoroughly cleansed before 
beginning to help in such a case. Hot water and 
plenty of soap should be used in preparing the hands 
for the work. Utensils, dressings, instruments and all 
water used for the case should be boiled. After clean- 
ing the hands with soap and water immerse them in 



Obstetrics 145 

a warm solution of mercuric chloride for three min- 
utes. This solution should be 1 : 2000. Convenience 
and accuracy will be secured by using tablets of the 
mercuric chloride. Have the nurse use the most rigid 
antiseptic precautions. 

The patient should take a warm bath at the begin- 
ning of labor, don clean linen and take an enema for 
the purpose of unloading the lower bowel. The ab- 
domen and thighs should be scrubbed with green soap 
and water. Douches should not be permitted in the 
vagina. Vaginal irrigation is not only useless but is 
harmful. The normal secretions of the vaginal walls 
are germ destroyers, they are nature's protection - 
against sepsis. We should not impair them by inter- 
fering with their function. The nurse should under- 
stand the preparation for the labor-bed and have 
everything ready for the reception of the child when 
it arrives. The labor-bed should have a stiff spring, 
a hard mattress and it would be more convenient if it 
is a single bed. A rubber sheet should be fastened 
on the mattress and covered by an ordinary sheet. On 
the middle third of the bed place another rubber 
sheet covered by a draw-sheet. Fasten both under- 
neath the mattress. The labor-pad may be placed on 
this when required. See that there is plenty of hot 
water at hand and a solution of boric acid for washing 
out the child's mouth and eyes. 

Some osteopaths do not use anesthetics but I prefer 
to use a little chloroform to deaden the pain. When 
too much is used it weakens uterine contractions. The 
patient's face may be covered with a slight coat of 



146 Osteopathic Gynecology 

vaseline as a precaution against the irritation which 
would be caused by dropping the chloroform on it. 
The nurse will sprinkle a few drops of the chloroform 
on a folded towel or mask held above the patient's 
face when each pain is about to come on. The anaes- 
thesia should be only partial. 

The physician should be somewhat of an adept in 
giving psychic treatment for he should have the full- 
est confidence of the patient. Whatever is told the 
relatives the patient should think that all is well and 
thus she will give her most intelligent assistance, for a 
satisfactory conclusion depends somewhat on the self- 
control of the patient. After the bowel and bladder 
have been evacuated he may proceed to the external 
examination. We may discover evidence of foetal 
movements and uterine contractions and by palpa- 
tion determine the height of the fundus and shape of 
the uterus and what portion of the foetus occupies the 
pelvis. By auscultation we may hear the foetal heart 
beat, about 150 per minute, the funic souffle, the pas- 
sage of the blood through the vessels of the cord, and 
the uterine bruit, the sound of blood in the vessels of 
the uterus. 

The center which controls parturition is found at 
the second lumbar vertebra and in case the external 
OS has not dilated to the size of a silver dollar, which 
it should have attained during the first stage of labor 
a little stimulation of this center as in No. 32 or 59 
will be found helpful. It will help the birth to be 
much quicker than without such stimulation. If the 
birth is taking place too rapidly the presenting part 



Obstetrics 147 

may be held back. Lacerations are very infrequent 
when a trained osteopath attends a dehvery. The 
uterus becomes very thin at the os, in places, while in 
other places of this circle they are thicker. The thin 
places tear and such lacerations are the cause of a 
great deal of nervous trouble in after years. The 
osteopath makes the thick places thin, he does this 
with his hand. One portion of the segment of the os 
is as strong as another and the danger of laceration 
is reduced to a minimum. In an osteopathic institu- 
tion where the birth records had reached over 3000 
there were but three lacerations and one of these oc- 
curred before the arrival of the doctor. Don't allow 
a birth to take place too rapidly and keep the rim of 
the OS the same thickness. 

Where there is a small pelvic capacity symphysiot- 
omy is performed, a separation of the pubic joint, by 
the regular physician. It is well known that this joint 
slightly separates during child birth and it can be made 
to open still more by lifting up the side of the pelvis 
of the patient. This may be done in the second stage 
of labor and it will make it easier in some cases. In 
case the placenta has not been expelled in half an 
hour it may be delivered by Crede's method of expres- 
sion and should be examined by the physician to see 
that no fragment has been left behind. The uterus 
should be gently kneaded for a half hour after the 
removal of the placenta. The abdominal binder is not 
put on for twenty-four hours. Wait until after the 
ascent of the uterus. This allows the uterus to ascend 
properly and the flow to begin. Do not use ergot ; it is 



148 Osteopathic Gynecology 

responsible for some cases of child bed fever. In 
primiparae after-pains due to the uterus attempting 
to expel clots of blood are seldom found to need re- 
lief. In multiparous women it will be well to massage 
the uterus frequently as this contracts it and there is 
not such an escape of blood. 

The patient should remain in bed for at least two 
weeks. This permits the uterus to regain its position 
in the pelvis. Allow the child to be placed to the 
breast for a short time every six hours until secretion 
of milk. If the child grows restless give it an ounce 
of sweetened water occasionally. When the flow of 
milk begins allow the child to nurse every two hours 
from 6 A. M. to 10 P. M., with an extra nursing in 
the night for the first two months. Nursing the child 
promotes the proper involution of the uterus through 
reflex nervous action. 

DIAGNOSIS OF PREGNANCY. 

The uterus increases in size by growth during preg- 
nancy; this is true in ectopic gestation (the foetus 
growing outside of the uterus). The lower part grows 
faster than the upper part during the first five months. 
The weight of this organ increases to about 24 ounces. 
The capacity increases from nothing to about 500 
cubic inches. 

At the end of the third month the fundus of the 
uterus has reached the brim of the pelvis. At the 
sixth month it has reached to the umbilicus and at the 
ninth month it is at the level of the lower ribs. The 



Diagnosis of Pregnancy 149 

cervix begins to soften about the second month and 
continues to do so to the end of the period. The va- 
gina, vulva and breasts become softer and in a relaxed 
condition. The mucous membrane assumes a bluish 
cast and there is more blood in the breasts. The 
areola becomes darker and the nipgles more prominent 
and softer. 

The vomiting of pregnancy begins during the sec- 
ond month and generally continues through the third 
month but may persist until the end of the term. 
There is considerable nerve tension and perversions 
of taste and smell. There may be neuralgia of the 
face and teeth. There may be digestive disturbances 
as the mother is eating for two and the stomach is 
called upon to perform extra work. 

The diagnosis of pregnancy requires considerable 
skill and should be made after repeated careful ex- 
aminations especially in the early stages. The sup- 
pression of the menses is a sign, but we should remem- 
ber that mental shock, anxiety, change of climate, and 
debilitating diseases act as a cause for this. We may 
presume a lady to be pregnant if she has frequent 
urination, is overly nervous, has morning sickness and 
suppressed menses. It is very probable that she is 
pregnant if there are uterine changes, as to color and 
shape with softening of the cervix. If there are mam- 
mary and abdominal changes. We may be positive 
that such is the condition if there are foetal heart 
sounds and foetal movements, when we should be able 
to produce ballottement. 



150 Osteopathic Gynecology 

DIET AND HYGIENE OF PREGNANCY. 

The diet of pregnancy should receive careful atten- 
tion. Sweets, fried food, rich sauces and all drinks 
that tend to overheat should be avoided. Diet has very 
little effect on labor as is sometimes taught. A mixed 
diet is desirable. The food should be digestible and 
nourishing. It should be sufficient to keep the mother 
in good general condition. There should be plenty of 
fruits and coarse cereals to avoid constipation. The 
food should be plain, simple and wholesome. An 
ordinary mixed diet will be found to fulfill all prac- 
tical purposes. Guard against overeating during the 
last months. 

Avoid carriage driving or riding over rough roads. 
Rough jolting should be avoided. Do not strain in 
any manner and avoid lifting. Do not perform any 
work that requires the hands to be held above the 
head. Walking in the open air is good. Exercise but 
do not carry it to excess. 

Wear loose clothing. Do not allow much pressure 
on the chest or abdomen. If the abdominal walls are 
soft and flabby use a supporter that exerts pressure 
upward. Bathe every day. The temperature of the 
water should be such as to cause no shock. Warm 
baths should be taken twice per week. Sexual inter- 
course will be avoided or at least very much restricted. 
It should never be performed at the menstrual dates. 
If there is a tendency for the nipples to retract they 
should be drawn out and manipulated for a few min- 
utes each day. White vaseline may be used daily on the 



Care of Mother and Child 151 

nipples for the last month to insure against fissures 
during nursing. 

Do not use drugs for headaches. Avoid calomel 
quinine and all of the coal-tar preparations. Their 
effect on the heart is bad. Avoid all excitement and 
sleep regularly eight hours. 

CARE OF MOTHER AND CHILD. 

Keep the temperature of the lying-in-room about 
70 degrees F. It should be well lighted and cheerful. 
Keep it very clean, removing all soiled clothes as soon 
as possible. Change the bed daily and keep the pa- 
tient quiet. Use the best aseptic precautions in car- 
ing for the mother. Change the valvular dressings 
every three hours during the first two days ; after that 
three times per day will do. Clean the external geni- 
tals with a cloth dipped in a saturated solution of 
boric acid. 

The mother has been hard at work bringing a child 
into the world and she needs plenty of good food. She 
may use her ordinary diet up to the beginning of la- 
bor. During labor, if it be prolonged, she should be 
persuaded to partake of broth, hot Horlick's Malted 
milk and any easily digested and nourishing food. 
After the ordeal she needs rest and being thirsty 
should have all the water she desires. Meat may be 
allowed the day after labor. It has been regarded for 
some time that it is no longer necessary to half starve 
a woman to keep down puerperal fever and " milk 
fever." We now use rigid antisepsis, hence there is no 



152 Osteopathic Gynecology 

danger in allowing ample food. Steak, chops, eggs, 
and cooked fruit may be given. The patient's own ap- 
petite is a splendid guide for feeding. The nursing 
mother should be careful to keep in good health. Con- 
stipation, indigestion and anaemia must be guarded 
against. If milk does not have any bad effects it 
should be used abundantly. The author has had splen- 
did success in using Horlick's Malted milk. He finds 
that there are so many ways of preparing it that it is 
relished by the mothers and has a beneficial effect on 
the mother's milk for the child. The mother should 
avoid emotional excitement and worry. Do not be- 
come overly fatigued. 

FEEDING THE INFANT. 

Infants brought up on breast milk are stronger and 
are better able to resist disease than those who are 
hand fed, for there is no food as good as mother's 
milk. When it can be furnished it is better than any 
mehod of artificial feeding and is a help in freeing the 
child from digestive disorders. When necessary to 
feed artificially it should be very carefully done as it 
is full of danger to the infant if carelessly performed. 

There are two methods of artificial feeding. Modi- 
fying cow's milk and adapting prepared milk to the 
need of each particular infant. For the poor in large 
cities condensed milk may be used. As it is deficient 
in fat and protein, cod-liver oil may be added to make 
up for the fat and egg albumen, or beef juice to sup- 
ply the deficiency of the protein. When using cow's 



Feeding the Infant 153 

milk the following formula is recommended for a 
child two months of age : 

Top milk, 8 oz. 

Barley water, 16 oz. 

Milk sugar, 6 heaping teaspoonfuls 

or Cane sugar, 4 heaping teaspoonfuls 

The child may take this until seven months old 
about 24 oz. per day; after that time the proportion 
may be changed to 

Top milk, 20 oz. 

Barley water, 20 oz. 

Milk sugar, 10 teaspoonfuls 

or Cane sugar, 5 teaspoonfuls 

Top milk may be obtained by skimming 6 oz. from 
a quart, then adding an equal amount of rich and poor 
milk. In case the above is hard to obtain equal parts 
of cream and ordinary milk may be used. 

When the child is one year old it can use milk 
modified with milk and water. Let milk stand six hours ; 
take six ounces from the top, the same from below 
and mix. Then add an equal quantity of barley water. 
When curds are vomited and there is indigestion sub- 
stitute barley water for a while instead of using plain 
water. -Barley water may be prepared as follows: 
Use two oz. of pearl barley to a quart of water, boil 
six hours, replacing the water as it evaporates. Strain 
through a cloth and add a little salt. When cool it is 
ready for use. 

The simplest and best plan will be to use Horlick's 
Malted milk and follow directions for feeding infants, 
which is furnished on request with the milk. 



■I 



PART IL 



EXPLANATION OF PART II. 

Wherever the word No. or Nos. is referred to in 
the directions for treating any disease it refers to the 
paragraphs from 1 to 139 and not to any illustration 
in this book. The paragraphs often refer to Fig. or 
Figs., which mean the illustrations and the illustra- 
tions only. 



PRACTICE OF 
OSTEOPATHY 



OSTEOPATHIC TECHNIQUE 

Tlie most important part of osteopathic pro- 
cedure is the examination of the patient, the de- 
termination of the lesion, the discovery of what is 
wrong in the human building. In some cases nature 
has taken care of a former abnormality of struc- 
ture, and then what was once abnormal has become 
normal. An attempt to make a forcible correction 
of the apparant abnormality would lead to trouble. 
In some cases most serious results would ensue. 

In other cases, where the real lesion is not dis- 
covered, months of routine treatment would be 
worse than useless and might be a detriment rather 
than a help to the patient. So we say the first thing 
and the most important thing to do is to make a 
careful and painstaking examination of the patient. 

If there are no marked osteopathic lesions, the 
disease in question having been brought on by 
overwork or abuse of function, as overeating or 
drinking, there are certain definite areas in which 
the Osteopath works, and by securing a better 
nerve and blood supply hastens the recovery of the 
patient. This is especially true in cases of sickness 
induced by the various specific microorganisms 
which are the exciting agents of a long list of 



8 Practice of Osteopathy 

acute diseases, as pneumonia, la grippe, typhoid 
fever, scarlet fever, measles, chicken pox, mumps, 
whooping cough, diphtheria, erysipelas, tubercu- 
losis, etc., etc. Even in many of these diseases 
there are predisposing lesions that weaken certain 
areas of the body and permit the entrance and 
growth of these exciting organisms. 

Yet in these very regions in which the Osteopath 
works to help recoveries there are, in a majority of 
cases, lesions of muscle, ligament, and of the bony 
structure as well, which have been induced reflexly. 
The abused organs or the diseased organs have 
sent nerve impulses to the cord, and they have sent 
them in such large numbers that they have in turn 
been sent out to the muscles and other structures 
lying in close proximity. A muscle is tense in pro- 
portion to the number of nerve impulses communi- 
cated to it. These abnormal nerve impulses, long 
continued, have produced contractures ; these in 
turn, by pulling on the bones to which they are 
attached, have produced bony lesions. Some of 
these bring pressure to bear on the spinal cord 
and other structures, and in this manner aggravate 
the disease. 

For the beginner in Osteopathy it will be better 
to have the back of the patient bare. If the patient 
is a lady, a gown or kimono may be worn which 
opens in the back. A suitable kimono for taking 
the treatment is illustrated in Fig 2. After the 
operator has had some experience he will readily 
examine the spine of patients through the gar- 



Osteopathic Technique 9 

ments, the under clothing at least. As a general 
thing we know very little about our own 
bodies. Many are more conversant with the normal 
cow, horse or hog than with the normal human 
body. It will be an excellent thing for the one who 
expects to make a vocation or even an avocation 
of Osteopathy to study carefully the normal body. 
Study a number of them. Become thoroughly ac- 
quainted with the normal body, and especially with 
the normal spine. In this way you will be all the 
more readily able to detect the abnormal. 

The practitioner should study the various de- 
grees of motility of the spines, joints, necks, backs, 
etc., of normal individuals. He should learn the 
various degrees of tension, tenderness, and pliability 
of the various muscles of persons in health. A knowl- 
edge of anatomy and physiology will be very helpful. 

Lesions. It is not every vertebra that is out 
of line laterally, or deviates anteriorly or posterior- 
ly, that may be said to be out of position in such 
a manner as to constitute a lesion. Before we can 
say that a deviation of such a character constitutes 
a lesion it ought to produce some pathological con- 
dition, or ill feeling of some kind. There should 
be some change in color and some temperature near 
the abnormality. There should be some contraction 
in the muscles and ligaments. There should be 
some inflammation, or a congestion bordering on in- 
flammation, near the seat of lesion. There will be 
pain in nearly all recent lesions. Pain will be 
present on pressure. In some conditions the 




Figure 1 



(10) 




Figure 2 



(11) 



12 Practice of Osteopathy 

muscles in close proximity will be slightly swollen 
and have a rigid feeling when worked over with 
the hand. It will be always safe and beneficial to 
manipulate the spine, ribs, ligaments, muscles, and 
other tissues, but do not attempt to correct a mis- 
placed bone until it is known to be out of place in 
such a manner as to cause pressure, or is forming 
an obstruction that is causing some illness. Never 
manipulate a tubercular joint or spine. Do not 
cause pressure on lymphatic glands. 

Diagnosis, Methods of. The method of diagnosis 
most in vogue and the principal one which the Os- 
teopath uses is palpation, the use of the hand or 
hands in determining the condition of nearly all 
the tissues of the body. With careful work and 
much practice, comparing the normal with the ab- 
normal, the sense of touch becomes very acute, 
and the least difference in the density and the 
motility of the various tissues is readily determined. 
The patient should be requested to relax all tissues 
as much as possible and not to make any resist- 
ance to the various movements unless requested 
so to do. The other methods of diagnosis are in- 
spection and percussion. With the beginner, in- 
spection is also important, as by it he notes curva- 
tures, unequal development of muscles, differences 
in the color of the skin, apparent age, height, 
weight, peculiarities of gait, manner of standing, 
sitting, etc. 

Percussion enables us to learn the condition, size, 
shape and position of various organs, the presence 



Osteopathic Technique 13 

of cavities, gas, tumors, etc. This form of diag- 
nosis calls into use a small hammer, but more gener- 
ally the second and third fingers of the right hand 
are used to strike the middle finger of the left hand 
which has been placed over the part to be percussed. 
In examining a patient it may be well to begin with 
the neck. 

EXAMINATION AND TREATMENT. 

The patient sitting, the examiner stands behind 
and notes any inequalities on either side of the neck. 
Sometimes one side bulges and on the other side 
there is a corresponding hollow. This condition 
indicates curvature in this region, with the con- 
vexity to the full side. On this side the tissues 
will be found to be hard, tense, and tender. When 
this condition is present it is frequently indic- 
ative of a curvature lower down. We now note 
whether there are enlarged tonsils, hypertrophied 
lymphatic glands, goiter, or any unusual pulsations 
or enlarged vessels. 

With the patient now reclining on the back in a 
comfortable position, with all muscles relaxed, we 
proceed with the examination by palpation. The 
neck may be gently manipulated by placing one 
hand on the forehead, for the purpose of rotating 
it by using the forehead as a lever, while the other 
hand manipulates the muscles in the back of the 
neck for the purpose of further relaxation. In ex- 
amination, as in treating, the Osteopath never rubs. 




(14) 



Figure 3 




Figure 4 



(15) 



16 Practice of Osteopathy 

He never allows the hand to slip on the skin, but 
is concerned with moving all the deeper tissues. 

The Osteopath now with the points of the fingers 
examines the tissues just beneath the skull. Often 
these are found tense, and the patient complains of 
pain here during examination and treatment. The 
fingers are now allowed to travel down the mid line 
at the back of the neck, and find the spinous proc- 
esses. The first one to be felt beneath the skin 
is the second, or axis. The position of the first, or 
atlas, is rarely determined by the spinous process, 
though in some cases, about one in fifty, it may be 
found. We are able to count the vertebrae in this 
manner and to note their position. The seventh, or 
vertebra prominens, has a very prominent spinous 
process. It can be differentiated from the first dor- 
sal, the one just beneath it, by rotating the head 
when the patient is in a sitting position and noting 
that the spinous process of the seventh cervical 
moves perceptibly while the spinous process of the 
first dorsal does not move. 

Anterior, posterior, or lateral deviations may be 
determined by the examination of the spinous proc- 
esses. The position of the transverse processes 
may be noted by turning the head to one side, mov- 
ing the examining fingers up a little and to one side 
from the spinous process. A prominent projection 
will be found when the one on the other side will 
be found in the same manner and the fingers will 
then move down from one to the next process on 
both sides, determining the relative position of each 



Osteopathic Technique 17 

with reference to neighboring processes. This en- 
ables us to determine lateral deviations, twists, or 
torsions of vertebrae; also posterior or anterior de- 
viations from the normal. 

Osteopathic treatment of the neck is for the pur- 
pose of removing lesions, which may consist of any 
departure from the normal in any tissue and which 
is causing abnormality of function. In following the 
description let us remember that all patients are not 
to be subjected to the same routine. This is too fre- 
quently done, to the detriment of the patient. What 
follows is for the purpose of describing the work in 
detail and to describe the work necessary for the 
removal of the various lesions usually found. This 
section of the book will be very frequently referred 
to by the numbered paragraphs where the descrip- 
tion of the specific treatment is referred to in the 
proper treatment of each disease. 

1. While the patient is in a sitting position on 
the side of the table, the operator, standing behind, 
the right hand placed on top of the patient's head, 
rotates the head so as to bring the neck of the pa- 
tient against the thumb of the operator's left hand. 
The left thumb is moved successively along against 
the arches of the vertebrae, as shown in Fig. 1. In 
this manner there is secured a free motion between 
the vertebrae, and the movement also assists in re- 
laxing the tissues preparatory to removing any ver- 
tebral lesion that may be present. 

2. The patient is sitting and the operator is stand- 
ing behind, and bends the neck of the patient as far 




(18) 



Figure 5 




Figure 6 



( 19) 



20 Practice of Osteopathy 

forward as possible on the chest of the patient. 
This stretches the strong posterior neck muscles, 
including the ligamentum nuchse. 

3. The patient sitting, the operator stands in 
front and puts his arm about the neck of the patient, 
so that the bend of the elbow comes beneath the 
chin of the patient, and the hand grasping the base 
to the skull. The other hand is free to manipulate 
any of the vertebrae in any desired direction, though 
this hold is more applicable to the atlas and the axis. 
The head of the patient may be given a lifting 
motion and moved over in the required direction. 
See Fig. 3. 

4. The scaleni muscles, the deeper ones at the 
side of the neck, are often tight and contracted. 
Pressure may be made on the first rib on the con- 
tracted side, as in Fig. 4, while the other hand bends 
the head forcibly to the other side, at the same time 
rotating the head. 

5. The patient lies on his back. The operator 
stands at one side with one hand on the patient's 
forehead, the other beyond to the other side of the 
neck. The hand on the forehead rotates the head 
from side to side, alternately relaxing and stretch- 
ing the muscles at the side and back of the neck, 
while the hand placed at the side of the neck 
stretches the muscles toward the operator with each 
movement of the neck. The hand on the neck will 
be moved from one position to another as the tis- 
sues relax beneath it, and the hand may be brought 
down onto the shoulder during the process of re- 



Osteopathic Technique 21 

laxation. This same treatment may be applied to 
all the tissues in front of the neck down to the 
clavicles. See Fig. 5. 

6. The hyoid bone may be found just above what 
is often called Adam's apple, the thyroid cartilage, 
the largest cartilage of the larynx. The bone feels 
as if it were shaped like the wishbone of a chicken, 
minus the protuberance at the angle. While it 
should be freely movable it is often held tight by 
the muscles, the supra hyoid and the infra hyoid, 
attached to it. This bone is frequently drawn back- 
ward and downward, and by pressure on nerves 
is the frequent cause of nervous coughing and may 
be responsible for complete loss of voice. By 
manipulating the neck from side to side the thumb 
and forefinger may be gradually insinuated under it, 
and it may be lifted up and forward. The tissues 
all about it should be thoroughly relaxed. See 
Fig. 6. 

7. The pneumogastric nerve may be pressed up- 
on, manipulated and stimulated by deep pressure be- 
hind the anterior border of the sternomastoid mus- 
cle on a level with Adam's apple, as in Fig. 7. This 
is a very important nerve, osteopathically, owing to 
its large distribution to important organs. 7 A. 
The spinal accessory and glosso-pharyngeal nerves 
may be reached by deep pressure upward and in- 
ward behind the angle of the jaw. 7 B. The sub- 
occipital, great occipital, small occipital, and great 
auricular nerves may be stimulated as in cases of 
fever, headaches, etc., by deep pressure on both 




0) 

u 

bo 



(22) 




Figure 8 



(23) 



24 Practice of Osteopathy 

sides of the spine, just at the base of the skull, as 
in Figs. 8 and 9. The founder of Osteopathy, Dr. 
A. T. Still, when but a small boy, made pressure 
on these nerves by placing his head in a swing. 
See Fig. 10. He found that this pressure relieved 
his headache. This accidental discovery may have had 
something to do with his discovery, later in life, 
of Osteopathy. 7 C. By deep pressure of the tissues 
of the neck against the transverse processes of the 
second and third cervical vertebrae we may stim- 
ulate the superior cervical ganglion. See Fig. 9 A. 

8. We will have occasion to refer to spring- 
ing the lower jaw by opening and closing the mouth 
against resistance. The operator stands behind the 
reclining patient, with hands under the chin and at 
both sides of the jaws of the patient, who is directed 
to open and close the mouth slowly, the operator 
resisting. This frees the tension of muscles and 
allows more freedom of blood vessels below the 
jaw. See Fig. 11. 8 B. In connection with the 
above the hands may be used to draw up the tissues 
under the chin. Let the movement be circular and 
deep. The points of the fingers are used to execute 
this movement. See Figs. 12 and 19. 

9. The head may now be twisted as far as 
possible to one side without causing inconvenience 
to the patient ; then to the other side in the same 
manner. We often notice in executing this move- 
ment that it moves further to one side than to the 
other. On the side to which it turns the least we 




Osteopathic Technique 25 

look for muscular or ligamentous lesions. See 
Fig. 13. 

10. The head may be pushed as far forward as 
possible onto the chest, loosening the posterior 
muscles and other tissues far down the spine. See 
Figs. 14 and 15. 

11. Some operators can use a very effective 
spiral treatment of the tissues of the back of the 
neck. One hand is placed on the forehead of the 
reclining patient, the other beneath the neck. The 
neck and head are both raised. The head is rotated 
in one direction, the neck in the opposite direction. 
Then the movement is reversed. See Fig. 16. 

12. A number of movements have been devised 
to reduce atlas lesions. One has been given above 
as in No. 3. These movements may be used in a 
slightly different way for the other cervical verte- 
brae. The operator stands at the head of the table, 
the patient reclining. The operator grasps the head 
firmly with both hands and makes pressure with 
the fingers against the arch of the atlas behind. He 
raises the head slightly, supporting it against the 
body. Now as he rotates the head he presses the 
bone toward the normal position. See Fig. 17. 

13. The neck tissues may be stretched as in Fig. 
18. In some cases it will be of material assistance, 
in the case of light patients, to have an assistant to 
hold the feet of the patient, to afford greater resist- 
ance. 

Many other movements in the treatment of the 
neck will be developed in the regular routine of 




(26) 



Figure 9 




< 

biO 



(27) 



28 Practice of Osteopathy 

practice by the skillful operator. This will be true 
of every portion of the anatomy as well as of the 
neck. 

THE HEAD. 

Most of the treatment for the purpose of affect- 
ing the head is given in the neck, upper dorsal and 
other portions of the body. Nevertheless the Oste- 
opath does some direct work on the head. 

14. While the patient is lying on the back the 
palms of the operator's hands are passed from the 
center of the forehead each way, with varying 
pressure down over the temples and behind the 
ears. This movement has a quieting effect on the 
patient, soothing the nerves, and is frequently used 
in headaches. It affects branches of the fifth nerve 
on the forehead. See Fig. 20. 

15. One palm is placed across the forehead and 
the other beneath the skull, or both palms may be 
placed on the forehead, one on top of the other, 
and great pressure exerted for a few seconds and 
repeated several times. See Fig. 21. This is useful 
in colds, headaches, etc., as it helps to relieve the 
pressure in the longitudinal and lateral sinuses, 
large veins of the brain. 

16. Treat along the midline of the skull, from 
the nose to the back of the neck, using the thumb 
in a circular, pressing motion with varying degrees 
of pressure for the same purpose as Nos. 14 and 15. 
See Fig. 22. 

17. We may tap with the knuckles or percuss 



Osteopathic Technique 29 

with one finger laid upon the center of the forehead 
in treating headaches, colds, etc. 

18. Manipulate on each side of the nose and 
loosen all the tissues for the purpose of affecting 
the fifth nerve and freeing structures in close con- 
nection with it. See Fig. 23. 

19. Use deep pressure, with a gliding movement 
of the little finger, to work over a portion of the 
fifth nerve, supplying the tear duct, for the purpose 
of opening it or keeping it open. Begin at the 
inner corner of the eye. See Fig 24. 

20. The forefinger will find a little depression 
in the skull, just below the eyebrows, between the 
center and inner margins of the eye, where the 
supraorbital branch of the fifth nerve emerges 
from the skull. It is a nerve of nutrition to the eye, 
and passes outward over the forehead at an angle 
of forty-five degrees. Free the tissues about and 
in this little opening with a gentle, pressing, cir- 
cular movement of the tip of the forefinger. See 
Fig. 25. Work along the nerve with the palm 
of the thumb. In some cases of neuralgia it will 
be found to be extremely sensitive, which will be 
greatly lessened as tissues are relaxed about it. 
In treating the eyes this nerve is often stimulated. 
The nerve may be felt beneath the skin. 

21. The fifth nerve may be treated where it 
emerges from the skull above the eye, in Figs. 
25 and 20. Also over both jaws, above and below 
the roots of the teeth. It may also be treated below 
the malar cheek bones, as in Fig. 26. It may be 



3i -' i' ' 


I 


L 


L 


f:y:-:-y 1 


1 


M'Sf'S: 


^w 



(30) 



Figure 10 




Figure 11 



(31) 



32 Practice of Osteopathy 

treated along the sides of the nose, as in Fig. 23. 
Thorough treatment of this nerve is frequently 
necessary in cases of neuralgia. 

THE EYES. 

22. The fingers must be very clean as they work 
inside of the orbit to tone up weak or contracted 
muscles in cases of strabismus. The finger may 
be inserted deeply, yet carefully, and worked around 
the eyeball, both to relax and free up the tissues 
and to promote a better circulation. 

23. The nail must be thoroughly clean as it is 
used to break up the little blood vessels which form 
a network running into the pterygia, which, if let 
alone, will grow towards and cover up the pupil of 
the eye. 

24. Granulations may be broken up by crushing 
them between the thumb and forefinger. For this 
purpose, folds of the lid may be lifted up, or one 
finger may be inserted beneath the lid. 

25. The patient, lying on the back, the eyeballs 
may be pressed back into the orbit several times 
with the palms of the thumbs and held there for a 
few seconds. This helps in toning up the various 
structures and assists in the general circulation of 
the eyes. 

26. The palm of one finger may be placed over 
the eyeball and tapped, as in percussion, by the 
forefinger of the other hand. This acts very much 
as No. 25, and is useful in cases of cataract. See 
Fig. 27. 



Osteopathic Technique 33 

THE SPINE. 

27. The patient sits on the side of the table and 
the operator notices any deviation from the normal 
in exaggerated curves, lateral curvature, or any 
number of vertebrae or a single vertebra which may 
be misplaced. He notes any tenderness, as he 
palpates with the fingers, that may be found in 
the tissues on either side of the spine or between 
the spinous processes. See Figs. 28 and 29 for 
fairly normal spines. 

28. The tips of the spines, the spinous processes, 
may be noted by the red color brought out on them 
by swiftly passing the hand over them with some 
pressure. In this manner their position may be 
noted, thus disclosing any deviation from the 
normal. 

29. A finger may be placed each side of the 
spinous processes and passed down, in this manner 
noting any lateral deviation from the normal. 
This may be done either on the bare spine or over 
the clothing worn in treating. See Fig. 30. 

30. The palm of the hand may be passed down 
rapidly, from the base of the skull to the sacrum, 
for the purpose of noting any deviations from the 
normal, either posterior or anterior. 

Pressure exerted on the top of the head, as in Fig. 
69, will frequently reveal tenderness at some point 
in the spine. 

31. The patient rests in the prone position, lying 
on his stomach, while the operator, with the palms 




(34) 



Figure 12 




CO 






(35) 



36 Practice of Osteopathy 

of the fingers, notes contracted muscular tissues, 
pulling the muscles away from the spine on either 
side. These contracted muscles often feel like 
small ropes beneath the fingers. See Fig. 31. 

32. The limbs of the patient are flexed as he lies 
on his side, and the operator holds them in this 
position as he gently springs the spine, as in Fig. 
32, noting its relaxed or contracted condition. 

33. While the patient is lying on the side in a 
comfortable position the vertebrae are carefully ex- 
amined by the fingers of the operator. Pressure 
is made between the spinous processes of each one, 
to note the condition of the ligaments and the ap- 
proximation or separation of the various vertebrae. 
See Fig. 33. When the ligaments have grown too 
thick they fill the spaces and produce what is 
known as the smooth, stiff spine. 

34. With the patient sitting on the side of the 
table, and the operator standing behind, he may be- 
gin the treatment of the back by placing the tips of 
his fingers on the patient's shoulders and with the 
thumbs loosen the muscular tissues in the upper 
part of the back. If the hands are long he can 
travel up and down a good portion of the back with 
the fingers in the above position. See Fig. 34. The 
fingers may now be used in relaxing all the tissues 
on the shoulders from the neck over the top of the 
shoulders. 

35. While the patient is sitting the operator 
passes one arm over one shoulder and under the 
opposite arm in front. With the other hand he 



Osteopathic Technique 37 

makes fixed points on the spine with the thumb, 
against which he rotates the body with the other 
arm, and in this manner thoroughly loosens the 
structures and replaces misplaced vertebrae. See 
Figs. 35 and 36. The position is reversed and the 
other side of the spine is treated in the same 
manner. The patient may be held, as in Fig. 68, 
one shoulder braced against operator's body. 

36. The patient sitting, and the operator stand- 
ing behind places one hand on the top of the 
patient's head and with the other hand makes fixed 
points with the thumb along the spine, using the 
head and neck as a lever. The use of the hands 
may then be reversed and the other side of the spine 
treated in the same manner. The operator will be 
surprised with the efficiency of this movement and 
the power that can be exerted at any given point 
along the spine against the thumb by making the 
right pressure on the head. See Fig. 37. 

37. The patient sits, preferably on a stool, and 
places his hands behind his neck. The operator 
stands behind and passes his hands under the 
patient's arms and takes his wrists and places one 
side of the flat of his knee at the patient's spine and 
lifts the patient up and backward against the knee. 
This is an efficient treatment for loosening the 
various articulations and stretching the ligaments 
which have become tightened. It stretches the 
spinal, scapular and neck muscles. The lower ribs 
are raised. See Fig. 38. 

38. The patient sitting, the operator stands to 




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46 Practice of Osteopathy 

one side and behind, or kneels beside the patient 
on the table, and passes one arm back of the 
patient's neck and under the patient's arm on the 
other side, thus bending the patient's neck forward. 
With the free hand fixed points are made along 
the spine and the patient's body is rotated against 
the thumb of the operator. This movement is 
very effective in upper dorsal regions. See Fig. 39. 

39. The patient sitting, the operator stands be- 
hind and places one knee beneath the arm of the 
patient in the axilla. This holds the shoulder and 
the ribs on that side in a fixed position. The 
operator may use one or both hands in raising one 
or more ribs or in stretching the opposite side. 
See Fig. 40. This may be used in combination with 
Figs. 46, 47. 

40. The patient is sitting, and the practitioner 
stands behind to one side and reaching around the 
patient in front grasps the lower edge of any rib. 
With the other free hand he raises the arm of the 
patient on the same side as he lifts the rib. This will 
be helped by having the patient take a deep breath 
as the rib and arm are raised, then holding both 
as the patient expels the air. See Fig. 41. 

41. The patient is sitting on a stool with the 
knees against the wall. The operator stands behind 
and places his knee on the appropriate round of 
the stool, with the knee against the vertebrae he 
wishes to correct, seizes the patient by the 
shoulders or under the arms and pulls the patient 
back against the knee, rotating the patient to make 



Osteopathic Technique 47 

the necessary correction of the spine. Extreme 
care must be exercised in executing this movement 
for fear of injury to the patient. See Fig. 42. 

42. The patient while sitting on the side of the 
table is bent forward so that his head is between his 
knees, the operator using forcible pressure on the 
upper dorsal region and head. This relaxes the 
ligaments of the lumbar and sacro-iliac regions. 
See Fig. 43. 

43. The patient is sitting on the side of the table. 
The operator is standing in front of the patient, 
with a pillow between himself and the patient. 
Both hands clasp the spine of the patient as in Fig. 
44, when deep pressure may be made, sinking the 
vertebrae well in ; then by rotating the body 
pressure may be made to the side wished. This is 
an excellent movement to correct a lateral curva- 
ture or any lateral or posterior displacement. In 
case of an anterior displaced vertebra the vertebrae 
above and below may be brought forward in this 
manner, thus gradually correcting the one which 
is anterior. 

44. The position is the same as in 43 for both 
operator and patient. By grasping the spine firmly 
on each side the patient may be lifted and the spine 
stretched, or correction may be made in this manner 
when only two or three vertebrae are approximated 
too closely. See Fig. 45. 

45. Fig. 46 shows an excellent movement in 
cases of spinal curvature. The side which is 
shortened may be stretched by using the wrist under 



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Figure 22 




Figure 23 



(49) 



50 Practice of Osteopathy 

the patient's arm, and the hand, as shown in the 
figure, raises and stretches the side. The other free 
hand moves from point to point along the spine 
and forces it over into position. 

46. The side may also be stretched, as in Fig. 47. 
Firm upward pressure may be made with the hand 
grasping the ribs while traction is made on the 
upstretched w^ist of the patient. 

47. The patient lies in as easy a position as pos- 
sible, with the face downward, but for comfort the 
face may be turned to one side, with the toes ex- 
tending over the end of the table. Let the arms 
hang over the side of the table. Have the patient 
relax as much as possible. The operator uses the 
palms of the hands in a circular, pressing move- 
ment to relax all contracted tissues of the back. 
See Fig. 48. With the cushions of the fingers he can 
pull the muscles away from the spine, as in Fig. 31. 

48. With the patient lying in the prone position, 
the operator standing at one side of the table grasps 
the hip of the patient on the further side in front. 
The heel of the other hand can then travel up and 
down the spine, exerting considerable pressure 
wdiile the other hand pulls the hip upward, giving 
the spine a torsion. The operator works from both 
sides. This movement is very effective in removing 
lesions and relaxing contracted tissues. See Fig. 
49. 

49. With 'the patient in the prone position, lying 
across the taaie as in rig. 50, the operax^a- stands 
at the head of the patient, and with the tshumbs 



Osteopathic Technique 51 

working each side of the spine he can further re- 
lax tissues and stimulate the nerves through the 
spinal cord. 

50. With the patient in the prone position, and 
the operator standing at the head of the table with 
the thumbs each side of the spine, as in Fig. 51, he 
can further relax the tissues and can also exert con- 
siderable pressure when necessary to correct poster- 
ior displaced vertebrae, or for the purpose of 
stimulating the spinal cord and through it the organ 
or organs which receive their nerve supply from 
any particular section of the spinal cord. 

51. The patient is in the prone position, and the 
limbs are raised in the operator's arm, as in Fig. 52, 
and rotated while the other hand makes fixed points 
with considerable pressure on the lower part of the 
spine. 

52. The patient is in the prone position, and 
pressure is made in the lower part of the spine, 
while first one then the other limb is raised, as in 
Fig. 53. This movement, as well as No. 51, assists 
the operator in relaxing the tissues and replacing 
posterior vertebrae. 

53. The patient lies on his side in a comfortable 
position. The operator stands in front and grasps 
the patient's uppermost arm, as in Fig. 54. With 
the other hand he relaxes the tissues about the 
shoulders and down to the spine and pretty well 
down the back, using the arm as he holds it at the 
elbow as a lever, working it back and forth to aid 
in the manipulation. The spine is manipulated 




(52) 



Figure 24 




Figure 25 



(63) 




Figure 26 



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Figure 27 



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(56) 



Figure 28 




Figure 29 



(57) 



58 Practice of Osteopathy 

and any deviations are corrected at the same time 
and in the same manner. 

54. The tissues may be so relaxed that the 
shoulder may be manipulated quite freely. One 
hand may pull up the scapulae, while the other 
presses on the shoulder, as in Fig. 55. The hand 
may also be insinuated under the scapulae, as in 
Fig. 56, and the tissues thoroughly manipulated 
and loosened. 

55. While the patient is reclining on the side, 
and one hand has made its way under the patient's 
scapulae, the other hand grasps the patient on the 
shoulder and rotates the entire shoulder. See Fig, 
57. 

56. The patient is lying on his side on the table. 
The operator places one hand beneath the patient's 
neck and grasps the occiput, as in Fig. 58. The 
operator brings his chest against the other side of 
the patient's head. In this manner considerable 
traction may be made on the neck and upper dorsal 
region, and very effective corrective work may be 
done with the spine with the free hand as shown in 
the cut. 

57. The limbs of the patient may be flexed and 
braced against the operator, who bends over and 
grasps the spine thus brought into relief, as in Fig. 
32. The spine at any point may now be manipulated 
by pulling it toward the operator. 

58. With one elbow on the hip, the other on 
the shoulder, as in Fig. 59, as the patient is lying 
on the side, the operator's arms may be extended, 



Osteopathic Technique 59 

thus stretching the hip away from the shoulder 
while the hands are free to manipulate tissues and 
the spine as well. 

59. The patient lies on the side, and the opera- 
tor, with one hand in front of the hip and the other 
hand behind the shoulder as in Fig. 60. By pulling 
on the shoulder and pushing against the hip the 
spine may be twisted for the purpose of relaxing 
tissues, including muscles, nerves and ligaments. 
With the same motion the side of the back upper- 
most may be stretched by separation of the opera- 
tor's arms. 

60. Fig. 61 is the exact opposite of the above, 
and the torsion is applied by reversing the position 
and motion. This is very useful for stretching 
and relaxing the various tissues of the back and 
spine. 

61. The patient lies comfortably on his back. 
The elbow of the patient is held by the operator 
with one hand, while with the other he reaches 
across the body of the patient and grasps the 
muscles of the back, as in Fig. 62. The arm may 
be stretched as movements are made to loosen the 
tissues manipulated with the free hand. The spine 
may also be manipulated with the free hand its 
entire length. 

62. The patient lies on the back, and the operator 
stands at the side of the table and reaches across 
the body of the patient and grasps the spinal edge 
of the scapulae, pulling it out as he brings the arm 
of the patient across the chest, as in Fig. 63. 




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Figure 34 



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Figure 35 



(65) 



66 Practice of Osteopathy 

63o A small patient lies on the back. The knees 
are grasped in one hand and flexed, as in Fig. 64. 
The free hand is introduced under the patient, 
grasping the lower part of the spine and manipulat- 
ing it as the knees are made to describe a circle. 
This is a very thorough method of manipulating 
the lower dorsal and lumbar regions of the spine. 

64. The patient lies on the back. The knees are 
flexed on the thighs and the thighs are brought 
forcibly against the abdomen. The pressure may 
be relaxed, then increased. This movement relaxes 
the ligaments and muscles of the lumbar and sacro- 
iliac regions. See Fig. 65. 

65. The fifth lumbar vertebra is frequently found 
posterior. With the patient on his back, the 
clinched fist of the operator is placed under the 
vertebrae and one limb at a time is taken by the 
ankle and forcibly put through the motion of ex- 
ternal circumduction, straightening the limb out 
with considerable force, thus bringing the weight 
of the body on the vertebra. 

66. In case the fifth lumbar vertebra is anter- 
ior the lesion is more difficult to reduce. The liga- 
ments may be loosened, as in Nos. 63 and 64, and 
the vertebra moved from side to side, as in Nos. 
35 and 57, thus gradually bringing it into its prop- 
per position. 

67. In case we desire strong inhibition, for tlie 
purpose of lessening the number of nerve impulses 
passing from any section of the cord to any given 
organs, we may hold the spine with a strong grip. 



Osteopathic Technique 67 

partially liftirTg the body from the table, as in 
Fig. 32; or we may place a book under the spine, 
requesting the patient to recline heavily upon it, 
as in Fig. 66. The position of the book, as indicated 
in the cut, is for the purpose of quieting the peris- 
taltic action of the bowels in cases of excessive 
diarrhoea. 

68. When the sacrum is found to be posterior 
it may be moved to its proper position in many 
cases by properly relaxing the sacro-iliac ligaments 
as in Nos. 47, 51, 52, 64. Then have the patient lie 
on the side of the table. The operator then places 
his knee against the sacrum and pulls back on the 
hip and shoulder, thus gradually forcing the sacrum 
into position. See Fig. 67. 

69. Another movement for restoring to its proper 
position a posterior sacrum is for the patient to sit 
on a stool. The operator places his knee against 
the sacrum, and holding the patient about the body 
rotates it as he pulls it backward, thus bringing 
pressure to bear on the sacrum. See Fig. 42. 

70. The coccyx is frequently misplaced. It can 
be manipulated after relaxing the tissues about it. 
Frequently it is found necessary to insert the fore- 
finger into the rectum, when the coccyx may be 
grasped by the thumb and finger and moved in 
the desired direction. This latter treatment should 
not be given oftener than once per week, and must 
be carefully done for fear of injuring the delicate 
tissues. 

71. The finger, anointed with vaseline, is inserted 




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Figure 37 



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Figure 38 




Figure 39 



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Figure 40 




Figure 41 



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Figure 42 




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76 Practice of Osteopathy 

into the rectum for various purposes by the Oste- 
opath. In doing so, time must be given for the 
sphincter muscle to relax. In piles, the finger 
presses the blood out of the congested veins, and 
with a circular, sweeping motion with the palm 
of the finger smooths out, frees and stimulates the 
action of nerves and blood vessels. In case the 
rectum is prolapsed it may be pushed up into posi- 
tion. 

72. The clavicle, or collar bone, is frequently 
found displaced. The sternal end, when out of posi- 
tion, afifects the tissues of the throat and is a promi- 
nent factor in diseases afifecting this region, in- 
cluding goiter and circulatory and nerve disturb- 
ances in the arms. The operator stands at the side 
of the table and takes the elbow of the patient, who 
is reclining, and inserts the fingers of the other 
hand under and above the clavicle, near the sternal 
end. Thje elbow is noAv brought over the breast 
of the patient and the fingers inserted more deeply 
under the clavical. This movement brings heavy 
pressure onto the fingers by the clavical, which re- 
sults in raising the latter, when the sternal end 
can be placed in or toward its normal position. 
See Fig. 70. This treatment may be applied at 
either end of the clavicle as the case may require. 

73. The clavicle may also be raised and placed 
in its normal position with the patient sitting, as 
in Fig. 71. The elbow is grasped and raised, which 
raises the clavicle, when the thumb may be inserted 
above and under it. By bringing the elbow upward 



Osteopathic Technique 77 

and across the chest the clavicular ligaments may 
be stretched and the clavicle properly replaced. 
This treatment is effective for either end of the 
clavicle. 

THE THORAX. 

In treating the thorax we must remember that 
the ribs are connected with the vertebrae, and that 
when the spine has a curvature, or one or more 
vertebrae are twisted or displaced in any manner, 
the ribs connected with those vertebrae are very 
frequently misplaced as a result. These combined 
lesions cause secondary lesions of the muscles, 
ligaments and cartilages. In correcting any malad- 
justment of the ribs advantage is taken of the mus- 
cles attached to them, especially the pectoral and 
latissimus dorsi muscles. 

74. The vertebral end, or head of the rib, is nearly 
a fixed point. Pressure exerted at the angle of the 
rib tends to move the rib about that fixed point. 
This movement is made more effective by the forci- 
ble elevation of the arm and in some cases by the 
rotation of the shoulder. 

75. The first rib is often raised near the sternal 
end. It may be depressed after the scaleni, the 
muscles of the neck, are thoroughly loosened. It 
may be depressed by pressure as the operator stands 
behind the sitting patient, as in Fig. 4. The head is 
bent forward and rotated, as in the cut. This 
stretches the scaleni muscles attached to the rib. 
The pressure is «till applied as the head is turned 
toward the rib. 




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86 Practice of Osteopathy 

76. The first rib may be also corrected as the 
patient is in the recumbent position, as in Fig. 72. 
The head is raised and rotated away from the rib, 
while the pressure is applied to the rib. Later the 
head is rotated toward the rib as the pressure is 
again applied. 

77. A further treatment for the first rib is applied 
as the patient is in the recumbent position, as in 
Fig. 72. With the head turned toward the affected 
rib and slightly elevated, pressure is made on the 
rib with the thumb, and the elbow on the same side 
is grasped and carried across the chest to the 
opposite shoulder. 

78. When the first or second rib is displaced 
downward it can be raised ; the patient sitting, 
the operator standing behind. The operator places 
the tips of the fingers at the lower border of the 
rib and lifts on it as he rotates the head, with the 
free hand, forward and then strongly backward. 
This uses the neck muscles, the scaleni, to pull 
the rib upward. Should the anterior cartilages 
protrude they may be pressed into position as 
the above treatment is being given. 

79. Should the first and second ribs need elevat- 
ing, nearer the spine, the operator may stand in front 
of the sitting patient while he presses and lifts up 
near the head of these rib^, while he rotates the 
head forward and to the opposite side with con- 
siderable force. See Fig. 73. 

80. The first rib may be depressed, with the 
operator sitting at the side of the patient with the 



Osteopathic Technique 87 

patient's arm across the operator's shoulder. This 
elevates the structures on that side. Pressure is 
now made on the upper border of the rib, just above 
the clavicle, as the head is rotated to that side and 
forward. See Fig. T^L. 

81. The practitioner stands in front of the sitting 
patient. One arm reaches around the patient, a 
little past the spine to the angle of the ribs, as in 
Fig. 47, while the arm of the patient is raised on 
the same side. The arm is stretched up and rotated 
back and down while the operator lifts on the angle 
of the rib. This serves to lift the rib in front as well 
as at the angle, because of the traction exerted on 
the pectoral muscles in front by the elevation of the 
arm. This motion should be carefully executed, 
yet sufficient strength should be used to make it 
effective. It may be repeated several times if 
necessary. The hand which holds the ribs may 
select one after another, as may be necessary, as 
the arm is stretched and rotated. In giving the 
above treatment the muscles, nerves, and ligaments 
are strengthened and toned. If one rib is very 
much lower than it should be the patient should 
take a full breath when the rib is pulled up, and as 
the breath is expelled the rib is still held for a few 
seconds. 

82. Fig. 46 represents another method of elevat- 
ing and separating ribs. The patient sits and the 
operator stands in front. The operator forces the 
spine to the side in question, which helps to separate 
the ribs. The arm of the patient is raised by the 




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96 Practice of Osteopathy 

wrist on that side, which raises the ribs. A com- 
bination of 81 and 82 is frequently effective. 

83. The patient sitting and the arm of the 
patient across the shoulder of the operator, as in 
Fig. 75. This gives more of a hold on the lower 
rib while the patient's head is bent away from the 
side being treated, curving the spine and throwing 
the rib more into relief. 

84. The patient sits on a stool and the operator 
stands behind, with his knee against the angle of 
the rib. With one hand the operator elevates and 
rotates the arm of the patient, and with the fingers 
of the other hand, beneath the rib in front, lifts upon 
it as the patient takes a deep breath. The entire 
treatment may be reversed and the rib depressed. 
See Fig. 41. 

85. The patient is sitting. The operator standing 
in front grasps the head of the rib in question, with 
one hand passed about the patient, while the other 
hand presses on the sternal end of the rib. By 
rotating the body of the patient the rib may be 
sprung into position. 

86. The patient is reclining on the back. The 
operator, standing to one side, reaches over and 
takes the arm of the patient on the other side. With 
the free hand he takes the rib at or near the angle, 
as in Fig. 62, and as he pushes it into place he 
lifts up on the outstretched arm and rotates it 
backward. This calls into play the anterior muscles 
attached to the rib or ribs and assists in the move- 
ment. The patient may further assist the operator 



Osteopathic Technique 97 

by taking a deep, full breath as the rib is lifted up, 
which the operator holds for a few seconds as the 
breath is exhaled. 

87. The patient may lie on the side. The 
operator uses the same general movements as in 
No. 86. This of course applies more to the upper 
ribs. 

88. As the patient lies in the prone position the 
heads or angles of the ribs may be replaced, as in 
Figs. 76, 50, 51, by working directly over them. 

89. When the patient lies in the prone position 
many cases of luxated ribs may be treated by pres- 
sure of the thumbs against the angles of the ribs, 
throwing the ribs either upward or downward, as 
indicated by the needs of the condition. 

THE ELEVENTH AND TWELFTH RIBS. 

90. These ribs are very frequently found dis- 
placed. The surrounding tissues must be fully 
relaxed. When the rib or ribs are displaced upward 
we have the patient lie on the side, with the limbs 
flexed on the abdomen, when the ribs may be 
grasped by the operator and pushed into position, 
forcing them upward. 

91. The patient sits on the side of the table, 
while the operator holds each end of the rib. The 
patient takes a full breath, and as the patient ex- 
hales, the rib is pushed into position. 

92. When the rib is displaced upwards the 
patient takes either position, lying on the side or 




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106 Practice of Osteopathy 

sitting, and the rib is manipulated, as in Nos. 90 
and 92, only in the opposite direction. 

93. Frequently we find the ribs flattened over the 
liver or stomach. They may be pulled out, as in 
Fig. 77 , Then they may be rounded into shape 
by using pressure on the ribs at the sides, as in 
Fig. 78. Repeated treatment in this manner will 
materially affect their shape. 

In treating and manipulating affected ribs or 
misplaced ribs we find it necessary to repeat the 
treatment. In some cases it takes considerable 
time, a number of treatments being necessary for 
permanent results. The ribs are so prone to slip 
back into their old positions when they have been 
out of position for a long tim-e. 

THE ABDOMEN. 

The Osteopath in examining the abdomen uses 
inspection, percussion and palpation. The latter 
conveys the most information concerning the con- 
dition of this important region and its contents. 
We note displacements of various organs, new 
growths, tumors, relaxed or tense conditions of 
the muscles, differences in temperature, enlarged 
or pulsating vessels, muscular contractions, dis- 
tended or contracted walls, etc. 

94. A general treatment of the abdomen is fre- 
quently very helpful, either for relaxing or toning 
muscular tissues, for increasing or decreasing the 
amount of blood in the abdominal vessels, and for 
its general effect on the nerves. The patient lies 



Osteopathic Technique 107 

on the back, with the knees flexed. The operator 
stands at one side of the table, and with the palm 
of the hand, not the tips of the fingers, relaxes the 
muscles of the abdomen. The operator may begin 
low down to one side and work up on that side, then 
on the other side in the same manner. The ribs may 
be slightly sprung inward to assist in the relaxation 
of the abdominal walls as they are undergoing 
manipulation, as in Fig. 79, which shows the general 
position of the hands. The abdomen may be 
spanned by the hands, with the thumbs on one 
side and the finger tips on the other side, and the 
abdominal contents moved in this manner from one 
side to the other. 

95. In treating any part of the body, but es- 
pecially the abdomen, the hands should be of such a 
temperature as not to be disagreeable to the patient. 
Cold hands used here will cause a contraction of 
the tissues, and thus interfere with the work. Direct 
pressure may be made with the flat of the hand, 
as in Fig. 80, over the center of the abdomen well 
below the umbilicus. Pressure may be gradually 
increased, with some side pressure to force the con- 
tents of the small intestine toward the caecum, the 
lower part of the large intestine which hes low down 
on the right side. 

96. It is often advantageous to lift up the intes- 
tines, as in Fig. 81. With the patient reclining, the 
knees should be flexed to allow of more thorough 
relaxation of the abdominal muscles. This move- 
ment should be repeated several times and the 



108 Practice of Osteopathy 

abdominal contents held for a minute or so each 
time. 

97. The patient is sitting, and the operator is 
standing behind. He places the sides of the palms, 
of the hands deeply beneath the abdominal contents,! 
as in Fig. 82. The patient is requested to bend 
forward as the operator twists his wrists, so that 
the sides of the hand next to the patient are turned 
inward and upward. Then request the patient to!| 
straighten up as the operator lifts the contents, 
and holds for a moment. 

98. The patient lies on the side, permitting a 
relaxed condition of the abdominal walls. The 
operator stands behind, as in Fig. 83, and lifts the 
abdominal contents upward, and may also lift them 
toward the median line, thus straightening out the 
caecum, or sigmoid flexure, as the position may 
allow. 

99. The operator may straighten out the sigmoid, 
and at the same time tone up the muscular tissues, 
by insinuating the palms of the hands deeply and low 
down on the left of the abdomen, and suddenly 
lifting the contents. The movement must be care- 
fully and cautiously performed. 

100. It is often of advantage, as will be indicated 
in various treatments, to tone up the solar plexus. 
This may be done by deep steady pressure, with a 
slightly circular motion just below the sternum. 
Pressure should be directed backward and upward, 
as in Fig. 84. 

101. The liver, spleen, and stomach and other 



Osteopathic Technique 109 

upper abdominal viscera may be toned by placing 
one hand on either side of the ribs, as in Fig. 85. 
Pressure, alternating with a few seconds of rest, is 
made as indicated. 

102^ The liver and adjacent abdominal viscera 
may be toned by alternating pressure and relaxa- 
tion directly over that organ, as indicated in Fig. 
78. 

103. The gall bladder lies underneath the ante- 
rior portion of the liver, just beneath the points 
of the ninth and tenth ribs on the right side. The 
bile duct leaves it at this point and proceeds to 
the duodenum, in the shape of a reversed letter '^ S '' 
when it enters that portion of the small intestine, 
about one and a half inches below the umbilicus. In 
cases of gallstones, or inflammation of the bladder or 
duct, we may assist nature in emptying the bladder 
and pass stones along the duct by manipulation. 

THE PELVIS. 

In the treatment of diseases peculiar to women, 
and some diseases peculiar to men, lesions of the 
pelvis play a most important part. One may never 
expect to efifect a cure while these lesions are permitted 
to remain. To remove them is of the greatest import- 
ance. 

Pelvic lesions will also be considered here because 
they afifect the limbs, causing sciatica, paralysis, en- 
larged veins, errors in circulation, etc. These lesions 
are often accompanied by spinal lesions, which al- 
so afifect the spine and through it other internal 




(110) 



Figure 68 




Figure 69 



(111) 



1 




3 



o 






(112) 




Figure 71 



(113) 




CM 






I 



(114) 




Figure TZ 



(115) 




1 



(116) 




Figure 75 



(117) 



118 Practice of Osteopathy 

organs. The discovery of these lesions requires 
considerable anatomical skill, and an attempt to 
correct lesions here should only be made when the 
operator is absolutely sure of his diagnosis. 

The whole pelvis may be tipped backward, in 
which case the superior posterior iliac spines will 
be found to be too prominent. In case the whole 
pelvis is on a torsion, one side back, the other side 
forward, one superior posterior iliac spine will be 
found prominent and the other less prominent than 
normal. In case one side of the pelvis is higher than 
the other, the superior posterior spine will be higher 
on the high side. The limb on the high side will be 
shorter than the limb on the low side. This may be 
determined by slightly manipulating both limbs to 
relax all tissues, and then comparing the internal 
malleoli of the tibia with each other. This may be 
done by placing them close together. Another way 
is to have the patient hold a tape line between the 
front teeth, and measure to the anterior superior 
spines of both ilia, and also to each internal malleo- 
lus of each tibia. In case the upper portion of the 
pelvis has moved forward, the superior posterior 
iliac spines will b'e found to be less prominent than 
in the normal pelvis. 

In making the examination the operator will best 
determine the condition by having the back bare. 
Great care must be exercised in making the examina- 
tion. The points of tenderness in case of luxation 
will be found over the sacro-iliac articulation, both 



Osteopathic Technique 119 

in the muscles and in the ligaments, interfering with 
nerves in the same region. 

104. When the pelvis is tipped backward have the 
patient sit on a stool or table. The operator stands 
behind and places his knee against the upper part of 
the sacrum, while he takes the patient beneath the 
arms and pulls upward and backward on the trunk 
with a rotary motion to first one side and then the 
ether. The assistant sits in front and draws the 
pelvis forward. See Fig. 42. 

105. For backward tipping of the pelvis the pa- 
tient may recline on the table with the face down. 
With one hand the operator makes pressure on the 
upper part of the pelvis, while he lifts the limb on 
that side with considerable force. This treatment 
is given first on one side then the other. 

106. For a backward tipping of the pelvis the 
patient lies on the side on the table. The operator 
stands behind. The knee is placed firmly against the 
sacrum, and the shoulder and the leg are both drawn 
backward. This forces the pelvis forward. See 
Fig. 67. 

107. When the pelvis is tipped forward the patient 
may lie on the side. The operator stands behind, 
and as he presses against the lower part of the sa- 
crum and pelvis with one hand he pulls back with 
the other hand from the upper part of the front of 
the pelvis, the anterior superior spine of the ilium. 

108. The patient sits on a stool, while the operator 
stands in front. The assistant is stationed behind 
the patient and holds the pelvis in front and draws 




U 

biO 



(120) 










(121) 



1 




?^ 



(122) 




u 



(123) 




o 

00 

s, 



(124) 




(125) 



18 




(129) 



Figure 82 




(127) 



I 



128 Practice of Osteopathy 

it backward, while the operator with his arms under 
those of the patient manipulates the body of the 
patient forward with a lifting, rotary motion. 

109. Should the pelvis tip upward on one side, 
the quadratus lumborum muscle may be stretched, 
as in Figs. 59, 60, 61. Then No. 108 may be applied, 
with the assistant holding down the high side of 
the pelvis. 

INNOMINATE LESIONS. 

We frequently have lesions which affect only one 
side of the pelvis. We often find one of the innomi- 
nates backward and downward at the same time ; 
again one will be upward and forward. The former 
will lengthen the limb on the same side, the latter 
will shorten it. These lesions are the most common, 
but we may find their exact reverse. We may find 
both innominates luxated in different ways or in 
similar ways at the same time. 

In order to determine these lesions we must de- 
pend on the position of the posterior superior iliac 
spines as indicated in lesions of the whole pelvis. 
We must compare the length of the limbs. Make 
measurements between the coracoids of the scapulae 
and the anterior superior spines of the ilium. Look 
for tension and tenderness in the sacro-iliac liga- 
ments ; also at the pubic symphysis. Examine the 
lumbar region of the spine for curvature or torsion. 
Compare the waist lines. We may measure also 
from the teeth to ilium and to the internal malleoli. 
See Figs. 86 and 87. 



Osteopathic Technique 129 

110. When the innominate is luxated backward 
have the patient He on the back. The operator places 
his fist beneath the posterior superior spine of the 
ilium. The other hand grasps the ankle and flexes the 
limb on the patient's abdomen, when the limb is rotated 
outward and downward with considerable force. 
In this manner the weight of the patient helps to 
force the innominate into position. 

111. The operator may grasp the crest of the 
ilium, and also the tuberosity of the ischium, and by 
alternately pushing on the one and pulling on the 
other may set either a forward or backward luxa- 
tion. This is done with the patient either lying on 
the back or on the side. 

112. Combinations of the above movements, 110, 
111, or the work used in correcting the whole 
pelvis, may be used in correcting any lesion of an 
innominate. 

THE LIMBS. 

The general treatment of the limbs may be modi- 
fied in various ways for the treatment of different 
and definite lesions. 

113. The limb may have various tissues relaxed 
preliminary to other work, by manipulating the 
various tissues by seizing the limb in both hands, 
as in Fig. 88, and with a rotary movement of the 
hands move and relax all the tissues to the bones. 

114. Both internal and external rotation and 
circumduction of the limb may be performed, flexing 
the calf of the leg on the thigh and the thigh on 




u 



(130) 



I 



I 




to 

00 

u 



(131) 




i 



(132) 




00 






(133) 




Figure 88 



(134) 



I 




as 

00 



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(135) 




(136) 



Figure 90 




Fionre ^1 



(137) 



138 Practice of Osteopathy 

the abdomen, then straightening the limb out with 
the proper rotation, with more or less force. See 
Fig. 89. 

115. The sciatic nerve may be stretched by ex- 
tending the limb, as in Fig. 90, at the same time 
bearing down considerably on the foot. 

116. The patient reclining, the knee may be 
slightly flexed and the operator works under it with 
both hands, stretching the muscles outward and 
working in quite deeply. See Fig. 91. 

117. The foot may be flexed, extended and 
rotated with considerable force on the ankle. Liga- 
ments and other tissues are thus relaxed and the 
circulation is promoted. See Fig. 92. 

118. In treating the feet the arches may be 
sprung to increase the arch, and pressure and trac- 
tion may also be applied to it. This relaxes liga- 
ments, permits of replacing misplaced small bones 
and tones up the muscular structures of the foot. 
See Fig. 93. 

119. The toes may be stretched and rotated with 
force at the same time. In some cases they must 
be handled with care. The treatment assists in the 
circulation by freeing all tissues, nerves and blood 
vessels. 

120. The saphenous opening, through which the 
long saphenous vein passes, lies one or two inches 
below the lower end of Poupart's ligament, on the 
inner side of the thigh. This opening is often prac- 
tically closed by tense muscles. It may be made 
free by external and internal rotation of the limb, as 



Osteopathic Technique 139 

in Fig. 89. Then the opening itself may be manipu- 
lated. 

121. The extended limb may be seized by the 
foot when the patient is in the reclining position, 
and turned outward as far as is comfortable for the 
patient, then be allowed to come to its normal posi- 
tion, See Fig. 94. This may be done, say ten times. 
Then it may be turned inward the same number of 
times. This movement puts the muscles on a strain 
by torsion, tones them up and assists in the cir- 
culation. 

Old subluxations cause considerable trouble. A 
slight misplacement at the hip is often treated as 
disease of the knee, neuritis, etc. These misplace- 
ments are not always discovered by the ordinary 
physician, but when the real cause is removed the 
case is cured. Reducing these luxations, when the 
case is an old one, requires a course of treatment 
to relax all muscular 'tissues, to render the parts 
flexible and the ligaments more pliable. 

122. AVhen we discover that the hip is dis- 
located, with the head of the femur up and back 
on the dorsum of the ilium, in which the limb is 
short and the toes turned inward, we flex the knee 
and rotate it inward. This frees the head of the 
femur. Then we rotate outward and make exten- 
sion while we press on the great trochanter to 
force the head into the acetabulum. See Fig. 95. 
This luxation comprises one half of all hip dislo- 
cations. 

123. The head of the femur is sometimes down 




(140) 




Figure 93. 



(141) 



19 




(142) 



Fignre 94 



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Figitre 95 



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(144) 



Figure 96 




Figure 97 



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(146) 



Figure 98 





Figure 99 



(147) 



148 Practice of Osteopathy 

and back near the sciatic notch. This also shortens 
the limb and turns the toes inward. The treat- 
ment is the same as above, as one writer puts it, 
'' bend up, turn in, roll out and extend." Use one 
hand to manipulate the great trochanter. See 
Fig. 95. 

124. Sometimes there is a thyroid dislocation 
of the hip, in which the head has been forced down- 
ward into the obturator foramen. In this case the 
knee is flexed and the toe points either inward or 
outward. To make the proper reduction the leg 
is flexed on the thigh and the thigh on the pelvis. 
The knee is rotated inward as far as possible, 
followed by extension. Pressure is made at the 
same time to force the head of the bone into its 
proper position. See Fig. 95. 

125. When the head of the femur is forward 
and onto the pubis the toe turns outward. The head 
of the bone can be felt and seen. Treat as in No. 
124. Should this prove unsuccessful place the 
patient on the side and draw the limb backward 
with considerable force, stretching all the muscles 
about the head of the bone ; then lift the head over 
the pubis and place it in its proper position. 

126. Ankle dislocations are reduced by simple 
traction. The knee is flexed on the thigh, the thigh 
on the pelvis. An assistant holds the knee and the 
operator holds and pulls the foot, giving it at the 
same time a slight rocking motion. See Fig. 96. 

127. Dislocations of the knee are reduced by strong 
traction. Pressure to force the tissues into place 



Osteopathic Technique 149 

may be made at the same time. The knee joint 
may be sprung by placing arm under the knee and 
pressing down on foot. See Fig. 97. 

128. In treating the shoulder and arm the 
shoulder may be rotated as in Fig. 57. The opera- 
tor grasps it before and behind the shoulder. 

129. The shoulder joint may be sprung, as in 
Fig. 98. The forearm of the operator is placed in 
the axilla, and the arm of the patient pushed toward 
the side. This relaxes tissues and frees up the cir- 
culation. It may be freed of adhesions and the 
circulation promoted by seizing the wrist, bringing 
it back and up under axilla and stretching out in 
front with force. See Figs. 103, 104. 

130. The elbow may be flexed on the same prin- 
ciple as indicated as in No. 129, by placing the 
clenched fist of the operator on the patient's arm 
just above the elbow and bending the arm upon 
the hand so placed. See Fig. 99. 

131. In some cases it is well to work carefully 
down the arm, rotating the muscles on the bones 
and working carefully on the forearm between the 
bones. See Figs. 103 and 104. Fig. 105 represents 
the stretching of the long head of the biceps, after 
which the arm will be flexed and the tendon pressed 
into its groove. 

132. All dislocations of the shoulder may be 
reduced by having the patient recline. The opera- 
tor places his stockinged foot in the axilla and makes 
strong traction on the arm of the patient. The 




o 

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bD 



(150) 







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(152; 




Figfure 103 



(1E3) 




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fe 






(167) 



158 Practice of Osteopathy 

knee may be used instead of the foot, as in Fig. 
100. 

133. In cases of elbow dislocations, where both 
bones are displaced backwards or displaced exter- 
nally or internally, or the ulna is backwards, the op- 
erator places his knee in front of the elbow joint, 
pressing against the ulna and the radius with the 
knee and bends the forearm. This plan uses the mus- 
cles to pull the bones into place. When the radius is 
backward the above or simple pressure, with ma- 
nipulation, may be used. For forward dislocation 
bend the elbow over the knee. Use extension and 
manipulation. See Fig. 101. 

134. The various wrist dislocations are all re- 
duced by traction. Some manipulations may be 
used. 

135. Should the ulna be dislocated at the wrist, 
pressure will be sufficient. 

136. For the various dislocations of the hand 
use pressure, traction and rotation. 

In many cases of old dislocations a prolonged 
course of treatment is necessar3^ 

137. A table and stool are represented in Fig. 
102. The stool is fourteen inches square on top 
and twenty-one inches high. The table is a folding 
one with a steel frame and thin wood top. It 
can be carried easily to the patient's home. One 
for regular office use would be padded and more 
substantial in design. The table represented in 
the cut is five feet and ten inches long, and twenty 
inches wide and twenty-six inches high. 



i 



Osteopathic Technique 



159 



138. A General Treatment is given by a great 
many Osteopaths in connection with the specific 
treatment needed for the ailment for which the pa- 
tient is being treated. General treatment is an advan- 
tage in a number of cases. It is given for nerve 
troubles and for the general circulation. The treat- 
ments will vary greatly with different Osteopaths 
but the following is a sample : 

139. The patient reclines on a table, lying on his 
side. The Osteopath begins by loosening up the 
tissues of the back, as indicated in Nos. 53, 56, 58. 
The shoulder is manipulated, as in Nos. 54, 55, 
the lower limb as in No. 113. The spine is 
sprung from one end to the other, as in No. 57. 
The patient then lies on the other side and the 
treatment is given as before. The patient then 
takes the reclining position, when further treat- 
ment is given the back as in Nos. 47, 48, 50, 51, 52. 

Afterward the patient lies on the back and the 
treatment is commenced at the head, as in Nos. 
14, 15.. 

The^ neck is treated as in Nos. 7B, 9, 10, 11, 13. 
The arms are treated as in Nos. 130, 131. 

Further treatment is given the back, and the ribs 
are raised as in Nos. 61, 62, 86, 64. The abdomen 
is treated as in Nos. 94, 95, 96, 100, 101, 102. The 
lower limbs are treated as in Nos. 113, 114, 115, 
116, 121. The patient now sits on the side of the 
table and the back and spine are further treated 
as in Nos. 1, 2, 5, 34, 36, 37, 43, 44. 



160 Practice of Osteopathy 

THE SPINE. 

The spine, in its normal condition, is a chain 
of flexible nature. It is formed of a number of 
bones called vertebrae, from the Latin vertere, to 
turn. There are thirty-three of these vertebrae, 
of v^hich seven are in the cervical, or neck 
region, twelve are in the dorsal region, w^hich oc- 
cupies the space from the neck to v^here the small 
of the back begins, five are in the lumbar region, 
the small of the back to the sacrum, five are in the | 
sacral and four in the coccygeal region, which is 
the coccyx. The twenty-four upper vertebrae 
should remain separate and flexible through life. 
Those in the sacral and coccygeal region, in the 
adult are firmly united and form two bones, the 
sacrum and coccyx. 

The spine has four normal curves, the cervical, 
dorsal, lumbar, and pelvic. The first, or cervical, 
extends from the base of the skull to the second 
dorsal vertebra. This curves inward. The dorsal 
curve extends from the second dorsal vertebra 
to the first lumbar vertebra. This is an outward 
curve. The lumbar curve extends from the first 
lumbar to the sacrum. This curve is a forward | 
one. The sacral curve begins at the union of the 
last lumbar vertebra with the sacrum and extends 
to the tip of the coccyx. This is an outward curve. 

In very young children the cervical and lumbar 
curves are absent, and when the child is sitting the 
spine presents only one curve from the base of the 



Osteopathic Technique 



161 



skull to the end of the spine, and this curvature is 
an outward one. The cervical and lumbar curves 
are called compensatory, and develop a little later. 
The curves of the normal spine should be frequent- 
ly examined, until the operator has a good idea 
of the normal spine. He should be acquainted 
with the normal flexibility of the spine as well. 



INDEX 

Part Page 
A 

Abdomen, Examination of, II 106 

Treatment of, II 107 

Advertising Quacks, I 115 

Abnormality, Careful of, II 7 

Amenorrhea, I 35 

Anaemia, I 93 

Anatomy, II 9 

Anteflexion of Uterus, I 53 

Anteversion of Uterus, I 48 

Anuria, I 80 

Aphonia, See Voice, Loss of, II 21 

Apoplexy, I 117 

Arrangement, of Vertebrae, II 160 

Arteriosclerosis, I 90 

Ascites, '. I 88 

Atlas, Examination of, II 16 

" Treatment of, II 21 

Axis, Examination of, II 16 

Treatment of, II 20 

B 

Back, the, .II S3 

" Examination of, II 33 

" Treatment of, II 36 

Big Neck, I 95 

Bartholin's Glands, No. a, I 14 

Bimanual Examination, I 23 

Boys of Fourteen, I 115 

Breaking-up Treatment of Spine^ II 37 

C 

Cancer, I 58 

Cartilage, Thyroid, II 21 

Cervix, '. I 45 

'* Examination of, I 23 

Change of Life, I 106 

Cheerfulness in Diseases of Women I 112 

Chest, Examination of, II 76 

162 



Index 163 

Part Page 

Chest, Treatment of, 11 11 

Chlorosis, I 93 

Clavicle, Examination of, II 1^ 

" Treatment of, II Id 

Clitoris, > I 13 

Climacteric, I 106 

Coccyx, Examination of, II 67 

*' Treatment of, II 67 

Constipation, I 84 

Contractures of Spinal Muscles, II 8 

Curves of Spine, Cervical, II 160 

'* " " Coccygeal II 160 

Dorsal, II 160 

in Infant, II 160 

Lumbar, II 160 

. " " " Normal, II 160 

Sacral, II 160 

Cystitis, I 78 

Cystocele, : I 43 

D 

Danger of Ladies at Menopause, I 106 

Danger in Treating, II 7 

of Newly Wedded, I 98 

" Men Over Forty, I 117 

" Young Children, I 113 

" Puberty, I 115 

Deformities, See Dislocations, II 139 

Desks, Schoolroom, Proper, I 26 

Deep Breathing, I 83 

Diagnosing Without Questions, I 20 

Diagnosis of Pregnancy, I 148 

Diagnosis, Methods of, . . ; II 12 

Disease, Prevention of, I 25 

" in Syphilis, I 104 

Dislocation of Ankle, II 148 

" Elbow, II 158 

'' Finger, IT 158 

" Knee, II 148 

" Hip, IT 139 

" Shoulder, IT 149 

. " " Toes, IT 138 

" Wrist, IT 158 

Dropsy, T 88 

Dorsal Region of Spine, IT 160 

" Curve of Spine, II 160 



164 



Index 



Pairt Page 

Dress, I 30 

Dysmenorrhea, I 40 



E 

Elbow, Dislocation of, II 

Treated, II 

Endometritis, I 

Examination, Preparation for, II 

of Abdomen, II 

" Atlas, II 

" Axis, II 

" Back, II 

" Clavicle, II 

" Coccyx, II 



Hyoid Bone, II 21 

Innominates, II 128 

Limbs, II 129 

Local, 

Neck, II 16,25 

Pelvis, II 109 

Pelvis, II 118 

Ribs, II 77,97 



" Rectum, II 

" Sacrum, II 

Bimanual, 

Instruments, 

of Vagina, I 

Exophthalmic Goiter, I 

Eyes, Treated, II 



67 
67 



22 
96 
32 



Fallopian Tubes, - I 17 

Fifth Lumbar Vertebra, II 66 

'' Nerve Treated, II 29 

Food, Good, Necessary, I 29 

Fornices, . I 15 

Frontal Sinus, II 29 



Gall Bladder, Located, II 109 

Ganglion, Middle Cervical, II 24 

" Superior Cervical, II 24 

General Treatment, Osteopathic, II 159 

'' " of Abdomen, II 106 

Goiter, I 95 



Index 165 

Part Page 

Goiter, Exophathalmic, I 96 

Gonorrhea, I 98, 31 

" Carefulness with, I 32 

" Treatment, I 32 

H 

Hands, in Treating, II 107 

Head, Examination of, II 28 

" Treatment of, II 31 

Hemicrania, I 65 

Hemorrhoids, II 76 

High Heeled Shoes, ! I 30 

Hip, Dislocation of, II 139 

Hymen, I 14 

Hymen, Injury of, I 14 

Hyoid Bone, Examination of, II 21 

Treatment of, II 21 

Hysteria, I 70 

I 

Iliac Spines, II 128 

Infant Feeding, I 152 

Infant, Normal Curve of Spine, II 162 

Inflammation of Bladder, I 78 

Inflammation of Uterus, I 60 

Inflammation of Veins, I . 91 

Inhibition of Spine, II 66 

Innominates, Examination of, II 128 

*' Lesions of, II 128 

Treatment of, ....II 129 

Insomnia, I 73 

Inspection, II 12 

of Spine, II 162 

Intestines Raised, II 108 

K 

Knee, Dislocation of, II 148 

Kyphosis, II 163 

L 

Labia Majora and Minora, I 13 

Laxus-Cycle, I 131 

Lesions, Determined, ....II 9 

'* Innominate, II 128 

'' Ligamentous, 1 1 25, 36 

'' Osteopathic, II 9 



166 Index 

Part Page 

Lesions, Pelvic, II 108 

Produced Reflexly, II 8 

of Ribs, II n 

" Spine, II 33 

Liganivintous Lesions, II 36 

Ligaments, Sacro-iliac, II (:il 

" Sacro-Uterine, I 45 

" Posterior, I 45 

Lateral, I 45 

Round, I 45 

Broad, I 45 

Limbs, Examination of, II 129 

Old Subluxations of, II 139 

Treatment of, II 139 

Lordosis, II 163 

Loss of Voice, II 21 

Lumbar Curve of Spine, II 162 

'* Region of Spine, . II 162 

M 

Men Over Forty, I 117 

Menorrhagia, I 39 

Menstruation, I 34 

Marriage Vows, I 124 

Methods of Diagnosis, II 12 

Migraine, I 65 

Metritis, I 60 

Mons Veneris I 13 

Mouth, Opened Against Resistance, II 24 

Muscles Scaleni, II 20 

N 

Neck, Examination of II 13 

" Spiral Treatment of, II 25 

" Treatment of, II 17 

Nerve, the Fifth, II 29 

Newly Wedded, I 98 

Nodules of Breast, I 110 

Normal Curves of Spine, II 162 

" in Child, II 162 

Spine, II 162 

Nose, II 29 

Nostrils, II 29 

O 

Obesity, I 11 



Index 



Obstetrics, 

Occipital Nerves, I 

Operations, Pelvic, 

Osteopathic Centers, »^ 

Osteopathic Lesion, 

" Treatment, General, 

" Stool, 

Table, 

" Technique, 

Ova, 

Ovarian Disease, 

Ovarian Tumors, 



167 

Part Page 
144 



21 

147 

132 

9 

159 

158 

158 

7 

121 

64 

65 



Palpation, I 

Pelvic Diseases Started in the Schoolroom, 

Pelvis, Examination, 

" Examination, 

" Treatment, 

" Treatment, 

Percussion, 

Peristaltic Action, 

Pernicious Anaemia, 

Physiology, Knowledge of, 

Piles, 

Pneumogastric Nerve, Located, 

'* '' Treated, 

Pregnancy, Care of Mother, 

'' Diagnosis of, 

'' Hygiene of, 

Preparation for Treatment, I 

Puberty, Dangers of, 

Prolapsus of Uterus, 

Prophylaxis in Syphilis, 

Puritus Vulvae, 



Reception Room, 

Rectocele, 

Rectal Treatment of Coccyx, I 

Rectum, Treatment of, I 

Reflex Symptoms in Change of Life 

Ribs, Twelfth, Examination of, 1 

" " Treatment of, I 

Treatment of, I 



12 

25 

108 

118 

108 

118 

12 

67 

93 

9 

76 

24 

21 

151 

148 

150 

8 

115 

46 

103 

Z2 



18 
44 

67 
67 

107 
97 
97 

106 



168 Index 

Part Page 

s 

Sacral Curve of Spine, ' II 160 

" Region of Spine, ,11 160 

Sacrum, Examination of, II 67 

Treatment of, II 68 

Salpingitis, I 62 

Scaleni Muscles, II 20 

Sciatic Nerve Stretched, II 138 

Sick Headache, I 65 

Schoolroom, Ventilation and Heat, I 26 

School Desks, Proper, I 26 

Shoulder, Dislocation of, II 149 

Treatment of, II 150 

Sex, Determination of, ; . . I 121 

Sexual Intercourse Prohibited, I 29 

Sexual Intercourse Prohibited, I 150 

Seminal Emissions, I 115 

Signs Preceding Menstruation, I 34 

Sinus, Frontal, II 29 

Lateral, II 28 

'' Longitudinal, II 28 

Smooth Spine, II 36 

Spinal Inhibition, II 66 

Spines, Iliac, II 128 

Spiral Treatment of Neck, II 25 

Sternum, II 77 

Stool, Osteopathic, II 158 

Subinvolution, I 61 

St. Vitus' Dance, I 81 

Syphilis, I 100 

T 

Tear Duct Treated, II 29 

Technique, Osteopathic, II 7 

Tic Douloureaux, I 74 

Thorax, Examination of, II 77 

Treatment of, II 86 

Thyroid Cartilage, . II 21 

Toes, Dislocation of, II 138 

Torsion of Spine, II 59 

Traction of Spine, II 25 

Treatment, Kimono for, II 8, 1 1 

of Abdomen, II 107 

" Atlas, II 25 

'' Back, II. ZZ 

" Coccyx, II 67 



Index 



169 



Part Page 

Treatment of Clavicle, II 16 

'' Eyes, ....II 32 

'* General Osteopathic II 159 

of Head, II 28,31 

" Hyoid Bone, II 21 

*' " Innominate Bones, II 128 

Tumors of Uterus, I 68 

u 

Uremia, I 79 

Uterus, Anteflexion of, I 53 

'* Anteversion of, I 48 

" Examination of, I 23 

Uterine, Sounds, I 24 

Tumors, I 57 

Uterus, I 15 

" Prolapsus of, I 13 

" Retroversion of, I 56 

" Retroflexion of, I 54 



Vagina, I 14 

Vaginal Examination, I 22 

Vaginitis, I 31 

Vaginismus, I 32 

Varicose Veins, I 92 

Ventilation and Heat in Schoolroom, I 26 

Venereal Infection, I 103 

Voice, Loss of, II 21 

Vulva, I 13 

Vulvitus, I 31 

W 

Wealthy Patients, I 

Wedded, Newly, I 98 

Womb, I 15,47 

Falling of, ! I 47 

Misplacement of, .'I 46 

Normal Position of, I 45 

Suspension of, I 16 

Tumors of, I 57 



Young Children, Dangers of, I 113 



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PRACTICE OF 
OSTEOPATHY 



Its practical application to the various dis- 
eases of the human body, illustrated with 108 
halftone engravings taken from original photo- 
graphs. 

A book of 335 pages of rare interest to every 
practitioner, who wishes to know all the ad- 
vancements of the healing art. 

This book will be sent prepaid in cloth for 
$3.00, in half Morocco for $3.75. 



WHAT TSi: MEDICAi:. PRESS SAYS. 

** This is a clear yet concise and thoroughly practical 
work on osteopathy." — Albright's Office Practitioner. 
(Phila.) 

" He presents the claims of osteopathy in a plain, 
simple and practical manner. Of great assistance to 
the medical profession. Well printed, handsomely 
bound."— Galliard's Southern Med. (Savannah, Ga.) 

" It is the best book we have seen from this school. 
The practical side of the science is presented in such a 
manner as to be of great practical importance to med- 
ical doctors." — ^The Med. Wor,ld. (Phila.) 

** The illustrations make everything clear and easy to 
understand. It is one of the neatest books that has 
come to our table in a long time." — The Okla. Phys. 
(Enid, Okla.) 

" We have not seen a book that was devoted to osteop- 
athic technique that was as plain, simple and so well 
illustrated as this one." — Am. Jour. Physiologic Thera. 
(Chicago.) 

Address MURRAY PUBLISHERS 

465 Douglas Ave. 

ELGIN, ILL. 



^-GL 



THE SUCCESSFUL PROMO- 
TIQN OF OSTEOPATHY 

^ The ideas contained in this book have helped 
a great many osteopaths to quickly obtain a 
practice. By putting these ideas into force splen- 
did practices have been built up. A number of 
osteopaths' who paid $2.00 for it wrote that they 
were greatly helped. 

The book gives the methods by which a practice 
grew from nothing to the treatment of 83 patients 
per month in one year. How in 3 months 50 pa- 
tients were being treated in a town of 2,500. 

What is the use of waiting " for something to 
turn up" when you are capable of earning from 
$5,000 to $8,000 per year? Your services are needed. 

The ideas in this book can be applied to any 
practice. Medical Doctors, Naturopaths, Chiroprac- 
tors, Mechano-Therapists, Drugless Healers, etc. 

The price on this remarkable book has been re- 
duced to 

All charges 
prepaid 



$1.00 



Address MURRAY PUBLISHERS 

465 Douglas Ave , Elgin, 111 

THE LAXUS-CYCLE 

For the use of th^ HOME, Osteopaths and Medical Doctors 

Corrects Lesions and secures a good circulation. Keeps the 

spine pliable. Keeps you young and makes you younger. 

For Prices Address 

The MURRAY PUBLISHERS 

465 Douglas Ave., Elgin, 111. 



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